Friday, September 07, 2012

NYT covers increasing strain on Medicaid from long-term care, likelihood that GOP will encourage states to enforce filial responsibility

The New York Times offers an important front page story Friday September 8, 2012 by Nina Bernstein, “With Medicaid, long-term care of elderly looms as a rising cost”, link here

As covered here before, Medicare does not normally care for nursing home or in-home caregiving (except for a short time when the patient is expected to get better). Medicaid can cover it when the patient has spent down assets to below certain numbers.  Federal look-back rules, going back for six years, prevent patients from giving away assets to adult children to qualify for Medicaid.

Also, as noted before here, many states have filial responsibility laws, which are rarely enforced, but there is an important recent case in Pennsvlvania (see May 22 on this blog, about John Pittas). 

Berstein’s article refers to “federal rules that now protect adult children from being billed for their parents’ Medicaid care.” I’m not sure what these rules are,  given the Pennsylvania case.

The GOP, if it gains enough political control in the November 2012 elections, wants to replace Medicaid federal participation (a term that I learned in the 1970s when working on New York State MMIS) with block grants that would give states more control, and some conservative states would probably become much more aggressive with their filial responsibility laws, given their budget problems. 

The article does cover examples of family members paying for their parents' long term care. 

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