The Horrors of Estate Recovery

New Orleans    The horrors visited on low-and-moderate income families are numerous and their damage inestimable and often devastating now and onward to future generations.  Even knowing this, it is still shocking to find additional examples hidden right before our eyes.

A case in point is estate recovery.  The Medicaid Estate Recovery Program in its present form is a legacy of the Clinton Administration.  Prior to 1993, estate recovery for repayment of Medicaid debts was voluntary, but President Bill Clinton signed the bill that year making it mandatory as a part and parcel of his deficit-reduction act and the false rhetoric of changing “welfare as we know it” and the mythical hype of personal responsibility as an antidote for poverty.  Much of the recovery was linked to the aging boomer population and the soaring costs of long-term care in nursing homes.

Medicaid, remember is not Medicare.  Medicare is available for those individuals over the age of sixty-five.  Medicaid is for the very poor.  Since the expansion of Medicaid through Obamacare, the Affordable Care Act, many understand how critical the program is for both the poor and lower waged workers.   In short, let there be no doubts on this score, this was a program deliberately designed and made obligatory in order to punish the poor by trying to raid whatever small estates that they might have when they die in order to impoverish their relatives as well as the deceased.

According to an article in the October issue of The Atlantic, the full level of the mean-spiritedness of this program is revealed, contrary to former Speaker Newt Gingrich and the Clintonista myth of the poor’s irresponsibility, in the almost infinitesimal level of recovery involved relative to the total cost of the Medicaid program or the long=term care program and its cost recovery, and the disproportionate horror it brings to the families trying to pay the bills.  As the story is reported in The Atlantic,

“…the overwhelming majority of estates are not worth hundreds of thousands of dollars.  In 2005, the Public Policy Institute of the AARP published a study of the first decade of mandatory estate recovery, Massachusetts, it found, recovered of $16,442 per estate in 2003,…offsetting a little more than 1 percent of long-term-care costs that year….In Kentucky…the average amount collected from an state was $93; the state recovered just 0.25 percent of its long-term-care costs.  The total amount states recouped jumped from $72 million in 1996 to $347 million seven years later – but even so, estate recoveries accounted for less than 1 percent of Medicaid’s total nursing-home costs in 2003.”

If it’s not just to hurt the poor and their hapless heirs, what’s the real point of this program?   It probably cost more cumulatively for states to administer the recovery program, than they are able to recover!

The Atlantic detailed one story after another of lower income families losing their homes or farms or their folks’ couple of acres and heirlooms passed on through the generations because of this predatory recovery.  The irony of the same program paying hundreds of thousands of dollars for operations and expecting no recovery compared to nursing home care is obvious.  The outrage that allows wealthy families to shield millions from taxation to bequeath to their heirs, while the poor are forced to become poorer and leave their own poverty as their inheritance to their children is equally obvious.

What excuse can there be for such a horror?

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What’s Up with Arkansas?!?

Milwaukee       No matter what P.T. Barnum once said, sometimes bad press is really bad press, even when they spell your name right, and that’s what seems to be happening in Arkansas now, thanks to the boneheaded right wing in the legislature and in Republican bureaucracy that is trying to punish the poor and lower income families.

The Economist is not what you could every confuse with a fake news, liberal, lefty rag.  It’s conservative, if not libertarian, on all manner of issues.  Nonetheless, there it was with both an editorial and a lead article slamming what it called “the Arkansas experiment” at denying Medicaid benefits to poor families because of onerous and inept reporting requirements for so-called “community engagement,” meaning work, volunteering or whatever.  The state was given the first such waiver in the country to allow it to essentially deny health benefits to the poor.  I’m already embarrassed for Arkansas, even as I write this much, but it gets much worse.  The Kaiser Foundation estimates that if all fifteen, largely Republican states that applied in me-too fashion to follow Arkansas were granted such waivers, it would push between 1.4 million and 4 million people off of coverage.

As The Economist reports in devastating fashion,

“The preliminary results from the Arkansas experiment look alarming:  18,000 people lost their health insurance in the first six months because they did not comply….Confusion seems widespread.  Many only realize they have lost insurance in the pharmacy, after trying to pick up a prescription they can no longer afford.  In some months more than 90% of those required to report their activities did not.  For the first few months reporting could only be done online.  More than 20% of those affected did not have access to the internet:  those that did found the website, which shuts down between 9pm and 7am, clunky and complicated.”

How can anyone from DHHS nationally down to Governor Hutchinson in Arkansas claim this is about “responsibility,” when their implementation is so completely irresponsible?

From there the Arkansas story becomes even more despicable.  The state has no way to count and isn’t much interested in doing so.  It’s own incompetence at determining where the reporting responsibility has failed or whether jobs changed, were lost or found is covered up by their own failure and whitewashed by Washington.  Hutchinson was left telling The Economist that he was sure one of the 18,000 “out there is healthy, has received a notice, understands the responsibility but just doesn’t do it.  And what do you do at that point? He asks.”  Wow!  I guess, Governor, you deny 17,999 in order to punish that one scofflaw bastard.  The ignorance and bias of his statement takes my breath away!

Oh, and then there’s the legislative fight to undue the will of the people in voting to raise the state minimum wage from $8.50 to $11 over coming years.  An Arkansas state house panel advanced legislation that would exempt “small businesses, some non-profits and teenagers” from a minimum wage hike approved by voters last November . On this one, Governor Asa Hutchinson and the state’s Republican party came out against the move. “I think the public has spoken on it and I think we need to abide by that,” Hutchinson said to the Associated Press.

Governor are you sure?  There might be one joker out there who will get the new minimum wage who you don’t think deserves it.  Don’t you want to punish everyone in the whole state of Arkansas in order to make them work harder because of that one guy?

Arkansas is going to have change its motto from the Wonder State to the WTF State soon.

Please enjoy Renée Wahl and The Sworn Secrets’ To the Bone.

Thanks to KABF.

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