[maxerickson]

It is interesting to see the reaction had on HN when someone like me, who recognizes the emperor has no clothes, comes along to critique a very real problem with one of these programs, Medicaid.

The analysis in your heavily downvoted comment is blatantly wrong!

Is Medicaid means tested? Absolutely.

Is Medicaid for elderly patients heavily means tested? Absolutely.

Is what you said: Medicaid enrollment as of 2016 reached over 70 million people. Here's the requisite chart:

https://www.statista.com/statistics/245347/total-medicaid-en....

Every single one of these people has, effectively, entered into a promissory note with the government. They DO NOT have health insurance, they have a loan. true? Nope, only people over 55 who have remaining assets are subject to estate recovery.

[rebootthesystem]

Everything I said is accurate. Yet, you insist in missing my greater point:

This issue shouldn't even exist.

We, as a society, should revolt at having such clauses in a medical program that is supposed to help people.

The US healthcare system should take care of every single US resident. Period. Rich, poor, healthy and ill. And it should do this without the kind of thing I have highlighted regarding Medicaid.

It is my experience that it is extremely difficult to convince people who have a religious attachment to things. So be it. I put the matter on the table. I've done all I could here to raise awareness. And that's the end of the story.

Be well.

[maxerickson]

It is my experience that it is extremely difficult to convince people who have a religious attachment to things. So be it. I put the matter on the table. I've done all I could here to raise awareness. And that's the end of the story.

Aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaagh.

The stuff you are complaining about only applies to people that are over the age of 55.

A 10 year old and their mother that get primary care through Medicaid, they don't ever have to pay anything back (except if they later access Medicaid after age 55, but the asset test would apply to the care received after age 55, not before 55).

[rebootthesystem]

> Aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaagh

So, you don't think it is immoral to have this estate recovery thing?

I don't know why you are focusing on this age business. It does affect a large number of people. And it is objectively wrong.

It is wrong because it is immoral and fraudulent to present it as insurance when it is not.

It is wrong because it is immoral and fraudulent to deceive people.

It is wrong for a country like the US to have a law that results in the government sinking it's hooks into a large percentage of the people on that program.

We should not have such provisions in any healthcare program at all. Period.

You are missing that one point. The most important of all.

Again.

We should not have such provisions in any healthcare program at all.

We should have programs that help people and provide healthcare for all with no such conditions or stipulations.

We should help the poor without having them give up whatever property they have or may have for the sake of having health care.

We need to be a better society and we can't claim to be that when we have a law that allows government to place a lien on someone's property because they had the misfortune of needing medical care.

As for all the means testing BS you continue to sling around. That went out the window with Obamacare. The only thing that matters now is a percentage of the Federal Poverty Level. It varies per State. In CA it's 138%, which means about $22K for an older couple who's kids have left the nest. Over ten million people have been shoved into Medicaid in CA (called Medical here) in 2016.

It turns out to be that a lot of fixed income older couples who own homes of significant value can easily fall under this FPL requirement. Hence, again, the over ten million people shoved into the program last year in CA alone.

You are sadly misinformed. I urge you to read the links I've provided in this thread so you can get a real picture of what's going on and how things work. I get the sense that you've had exactly zero contact with this system from any imaginable angle. I and my family have, from both the professional angle --my wife being a Doctor-- and the patient angle, with my parents and her parents.

Here's yet another link:

https://www.healthinsurance.org/california-medicaid/

And here's a quote from that article:

"This has become more of a problem since the ACA’s Medicaid expansion took effect in 2014, as people are now funneled into the Medi-Cal system in much greater numbers than they used to be. Covered California enrollees with income up to 138 percent of the poverty level are directed to Medi-Cal, regardless of the value of their assets (there’s no asset test for subsidy eligibility or Medicaid coverage under the ACA).

As a result, some families have been receiving bills from Medi-Cal after their loved ones pass away, including bills to cover the cost of payments that the state makes to managed care plans, even if the deceased didn’t use any medical services."

Let that last line sink in: "EVEN IF THE DECEASED DIDN'T USE ANY MEDICAL SERVICES"

The famous line from The Matrix applies here:

"You take the blue pill, the story ends. You wake up in your bed and believe whatever you want to believe. You take the red pill, you stay in Wonderland, and I show you how deep the rabbit hole goes."

I've shown you where the rabbit hole goes, yet you continue to believe whatever you want to believe despite overwhelming factual evidence. I can't fix that. Enjoy that steak.

[maxerickson]

As for all the means testing BS you continue to sling around. That went out the window with Obamacare. The only thing that matters now is a percentage of the Federal Poverty Level. It varies per State. In CA it's 138%, which means about $22K for an older couple who's kids have left the nest. Over ten million people have been shoved into Medicaid in CA (called Medical here) in 2016.

Checking income is a means test.

As for why I keep bringing up the age thing, it's because you keep making incorrect claims where it is a relevant factor and statements implying that receiving Medicaid benefits has grave financial consequences for all recipients (receiving the benefit doesn't even have grave financial consequences for the elderly; it just isn't very generous).

[rebootthesystem]

"means testing" refers to something very specific which includes asset valuation.

Obamacare/ACA/Medicaid no longer include means testing. It's a simple income test against FPL.

Where did I say that Medicaid has grave financial results for all recipients?

Again, you continue to ignore the point:

The fact that these hooks exist in Medicaid is objectively wrong. Very wrong.

They (the hooks) are also very real and, yes, they affect millions of people. So real that there are myriad attorneys specializing in complicated asset protection schemes intended to shield people from them.

The trouble is this is only available if you have the money to afford some very expensive and complicated legal work.

In other words, the poor and lower middle class are totally screwed and can't defend against this. This is horrible.

We should not do this to our people.

--

1- Are you saying it is OK for Medicaid to have estate recovery rules?

--

2- Are you saying estate recovery isn't real?

--

Please clarify because I truly don't understand where you are coming from.

[maxerickson]

Means testing has a broad and non specific meaning. Wikipedia of course isn't authoritative, but it discusses it in broad terms: https://en.wikipedia.org/wiki/Means_test

As an example, due to the pension my father left her, my mom will never qualify for any Medicaid assistance. This is a means test, she has resources above what Medicaid would provide.

The poor don't have assets to scheme to protect, so they don't really get screwed by asset tests.

The resources for elder care have to come from somewhere. Having the people receiving the care be the first payers makes a lot of sense to me. So the asset tests don't really bother me much.

Should society step in and help people who can't afford to pay? Of course. Should society work hard so that middle class and wealthy people that need long term care can pass more of their assets to their children? Probably not.