Tag Archives: Medicaid

Government Policies and Inflation are Making the Poor Even Poorer

San Juan   There was something to celebrate on the first day of a new decade.  President Trump for only the second time in his term of office did NOT tweet.  What a relief! The other time was the day after the Mueller investigation report was made public.  This time, who knows?  He may have been kidnapped for the day by a roving band of pirates off the coast of Florida.  Maybe they came from Puerto Rico in protest of the lack of support for their hurricane recovery because of, as some may remember, his earlier claim that the island territory was “in the middle of the ocean” and too far away to help.  Certainly, almost all the restaurants in San Juan were closed on New Year’s Day, so the wait staff could have been the ones manning the boats.  I’m not sure.  I’m just offering some alternative facts.

The war talk and chest thumping over Iran pulling the strings on a US embassy takeover in Baghdad did decrease as the protestors withdrew after the Iraqi government promised to support a resolution asking the US to withdraw troops from that country.  On the other hand, the war on the poor continued to accelerate as the Department of Agriculture doubled down on its plan to take another 700,000 people off of food stamps.  The Secretary claimed it is all about getting them to work without reckoning with the fact that most recipients are already working, they just aren’t making enough to adequately and healthily feed their families.  The New York Times Upshot column noted that when lower income families ate better it saved $1400 a year per person in health care costs and had led to reductions in Medicaid spending in a number of states.  Does the administration care or is this all about a body count?

Even as many bemoan the rising gap between the rich and the poor and the federal government pushes to make the poor even poorer, other studies, including a recent one from a team of researchers connected to Columbia University and the Groundwork Collaborative have found that they are already poorer than previous statistics had determined.  Reported in The Hill, they found that “Real income for low-income Americans fell more than 7 percent between 2004 and 2018, in part because of rising costs for items and services purchased by those Americans.”

Inflation in goods that are already more highly priced for poor families is under-reported, making the income gap experienced by lower income families more pronounced.  Seven percent may not sound like much, but in a country the size of the United States it means that,

Using their inflation measure, the paper’s authors estimate that 3.2 million more people would fall below the poverty line, bringing the nation’s total to 41.4 million. The U.S. population in 2018 was about 327 million.

It seems hardly the time to intensify the war on the poor, when they are already getting poorer.  What would it take to get the Trump administration to finally negotiate a peace in this war and withdraw its bureaucratic troops at USDA, DHHS, DHS, and the other agencies?  It’s past time!


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?