Hook Law Center: For Medicaid, Long-Term Care Costs of Elderly are Rising

It should be no surprise that the costs for the long-term care of the elderly are rising. The baby boom generation is now aging, and there are many more of them to take care of. Many of their parents are still requiring services as well. While some people may think only the indigent utilize Medicaid to pay for in-home care or a nursing home, think again. Many middle class people are accessing Medicaid’s benefits, too, because longer lives are requiring more financial resources than ever before.

Medicaid is an extremely costly program. “Medicaid spends more than five times as much on each senior in long-term care as it does on each poor child, and even more per person on the disabled in long-term care.” (Nina Bernstein, “With Medicaid, Long-Term Care of Elderly Looms as a Rising Cost,” The New York Times, September 6, 2012) The presidential election could have a profound effect on the future of Medicaid. Republicans are proposing to replace Medicaid with block grants that reduce spending by a third over the next 10 years. With their proposal, states could change such things as minimum eligibility, standards of care, and federal rules that now shield adult children from the liability of paying their parents’ Medicaid bill. (Bernstein, see above)

Experimentation with such cost-cutting ideas is already underway in some states through the waiver mechanism. 26 states are seeking or have obtained waivers, including New York, California, Illinois, and Texas. These are states with large populations. If they can successfully tinker with Medicare, then other states may follow their lead. Look at New York, for example. It has the biggest Medicaid budget in the country– $54 billion. 41% of that amount is spent on long-term care, and almost half of that 41% is spent on nursing home care.

By 2015, New York will start requiring 78,000 nursing home residents to enroll in a choice of managed care plans or randomly be assigned to one. (Bernstein, see above)

However, some doubt the success managed care will have. H. Stephen Kaye, a professor at the Institute on Health and Aging at the University of California, San Francisco is one who thinks there is not much evidence about whether managed care saves money in the long run for those who need long-term care. What could happen is the unintended consequence that there will be an increase in requests for in-home care. “While home care is generally much cheaper than nursing homes, states may wind up unleashing a pent-up demand for home care from eligible people who could never have entered a nursing home anyway.” (Bernstein, see above)

So stay tuned. Currently, even with Medicaid coverage, individuals/families are supplementing costs for nursing homes. Individuals/families pay 22% of the $178 billion expended for nursing home care. (Bernstein, see above) This percentage is likely to rise, no matter who wins the presidential election. The public wants the coverage, but they want someone else to pay it. One thing is sure–medical costs are certain to rise as more is learned about prolonging life. The only thing that is not certain is who is going to pay for that care. The attorneys at the Hook Law Center can assist families confronting the high cost of long-term care for a loved one by assisting them in qualifying for VA and Medicaid long-term care assistance.

Hook Law Center has been providing the highest quality of legal advice to the communities of Hampton Roads for more than 80 years. Our practice is dedicated to seniors, and disabled persons, their families and advocates. Our professional staff can respond to our client’s care needs on a 24 hour basis, and our Attorneys are available to provide expertise on every issue facing senior citizens from long-term and life care planning to estate and trust issues as well as financial, investment, public benefit, and insurance assistance. Visit their website for more information.


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