By Dave Ranney
KHI News Service
TOPEKA, March 13
Someone with a lot of money and a big house should have a hard time getting Medicaid to pay their nursing home bills.
But they don”t, said Stephen Moses, president of the Center for Long-Term Care Reform, a conservative think tank based in Seattle.
It”s easy, he said, for the elderly to hide or give away their assets, creating an impoverished appearance.
“We”ve turned Medicaid into free inheritance insurance for the baby-boom generation,” Moses said during a Tuesday appearance before the House Republican Task Force on Health Care.
Attendance at the meeting was limited to the task force”s chairman, Rep. Jeff Colyer, R-Leawood, and Rep. Clark Schultz, R-Lindsborg, and a few onlookers.
Moses warned that Medicaid was never intended to bankroll the nation”s long-term-care needs. Unless something is done to correct that, the system is sure to implode in 10 to 20 years, he said.
Moses recommended that when long-term care eligibility calculations for Medicaid are done that they include the individual”s asset transfers for the previous five years.
“We need to get Medicaid back to its roots, to target it more effectively to people who are truly in need,” Moses said. “We need to create stronger incentives for everyone else who”s healthy and affluent enough to buy insurance
or if they chose not to do that, to at least use their home equity.”
Moses is nationally known proponent for long term care insurance.
Moses” comments seemed off-target to Molly Wood, an elder-law attorney in Lawrence.
The state”s asset-recovery laws already go back five years, she said.
“What he”s saying resonates in the abstract
sure, millionaires shouldn”t be on Medicaid,” Wood said. “But I defy you to go to any nursing home in Kansas and find one person who”s on Medicaid who owns a $500,000 house.”
Wood is a past president of the Kansas Chapter of the National Academy of Elder Law Attorneys.
Kansas” eligibility standards are in full compliance with federal laws, said Megan Ingmire, spokeswoman for the Kansas Health Policy Authority, which oversees the state”s Medicaid programs.
“We expect people to use their assets before they seek Medicaid,” Ingmire said. “This is a deeply complicated legal issue under federal and state law. Our responsibility is to make sure people meet those requirements under federal and state law. We want to be sure individuals are receiving the care and assistance they need, however, we must be stringent to ensure that individuals are not abusing the system and provide that all federal and state requirements are met.”
Cindy Luxem, executive director at the Kansas Health Care Association, said Moses is correct in his urging people to take responsibility for their own long-term care.
“People need to be good, responsible consumers
that”s what he”s saying, and we agree with that,” she said.
The Kansas Health Care Association represents the state”s for-profit nursing homes.
But Luxem disputed Moses” notion that families are scamming the system.
“That is the last situation a family wants to find itself in,” she said. “On a personal note, I went with my dad to apply for Medicaid because he simply did not have the resources to pay for mother after she had to be in a nursing home. It was a rough thing for him to swallow. I can”t imagine anyone going through that unless they had no other choice.”
-Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
dranney@khi.org
or at 785-233-5443, ext. 128.