My friend Stephen Moses, president of the Center for Long-Term Care Reform, has been a consistent and persistent advocate for reforming the Medicaid system and getting Americans out of the Medicaid-dependency mindset. He just published, with the Paragon Health Institute, the follow-on to his paper “Long-Term Care: The Problem.” Available now is “Long-Term Care: The Solution.”
While I was hoping for something completely new and creative, I can’t disagree with his recommendations, which include 1) stop the ability to purchase Medicaid-exempt assets, 2) eliminate the home equity exemption, 3) ban Medicaid Asset Protection Trusts, 4) disallow Medicaid compliant annuities, and 5) increase the five-year asset transfer look-back to 20 years, from the five years today.
Something does have to be done, because Medicaid was established to take care of the truly poor and indigent. With all the protections allowed today, listed above, Medicaid has reached into the middle class and upper middle class, not the intended beneficiaries. The problem is that there are so many loopholes, used by so many people, that we wonder who will push to get them removed, other than Steve. But the mindset does have to change, because there will not be enough money to go around when the boomers age into senior care facilities. There were recommendations to get there, but it will be a slow process, if it happens at all. But let there be no mistake, it does have to happen.
