Medicaid Spend Down

Proposed health care cuts loom for San Joaquin residents, economy

STOCKTON - As hard hit as the county and state economies are right now, they can expect more tough blows with major budget cuts proposed for Medi-Cal by lawmakers in Sacramento and Washington.

In California, the public health-insurance program for low-income individuals is known as Medicaid.

With 163,000 residents qualifying for Medi-Cal in San Joaquin County - a figure that represents about 24 percent of the population and includes 90,000 individuals up to 21 years old - no one is doubting the importance of Medi-Cal's role as a means to access health care and in its impact on the economy.

"It may be 1 to 3 percent of whole economy, but that's arguably significant. We are a little bit more Medicaid dependent than the national average. I think San Joaquin County would be a little more adversely impacted than other parts of the country," said University of the Pacific economics professor Peter Hilsenrath, who holds the Joseph M. Long chair in Health Care Management.

The federal and state dollars that come into the county through Medi-Cal pay part of the salaries of thousands of physicians, nurses and allied health care workers. Those funds also help purchase millions of dollars in materials and supplies from local businesses, Hilsenrath explained.

"If you have to lay off the staff at nursing homes, they have less income to spend on groceries and such. ... It also depends on what else is going on in the economy. It becomes a little more painful when you don't have the ability to move people from one sector of the economy to another," Hilsenrath said, referring to the county's lack of jobs that translates into high unemployment.

The cuts to Medicaid, if implemented today, would have a devastating impact on the struggling economy of California, according to the new report "Jobs at Risk" released Wednesday by the national health care consumer organization Families USA. These cuts would put as many as 187,690 jobs and as much as $24.4 billion in state business activity at risk.

"Every federal Medicaid dollar that flows into a state stimulates state business activity and generates jobs," said Ron Pollack, executive director of Families USA, based in Washington.

"Conversely - and tragically, for California - cutting Medicaid funds not only hurts seniors, people with disabilities and children who count on the program as their lifeline, but it also results in fewer jobs and stunts the economic recovery.

Medicaid Spend Down - News

Proposed health care cuts loom for San Joaquin residents, economy

In California, the public health-insurance program for low-income individuals is known as Medicaid. With 163000 residents qualifying for Medi-Cal in San Joaquin County - a figure that represents about 24 percent of the population and includes 90000

Once-powerful nursing homes take a 6% hit in new budget

care and less to institutional care spend less per person. According to administration projections, 58 percent of Medicaid long-term-care spending will be devoted to institutional care by the end of 2013, down from 64percent this year.

Court won't halt Medicaid cuts

Enrollment in the "spend-down" program ended May 1, and it will be eliminated Oct. 1, saving the state $70 million. The rest of the AHCCCS cuts awaits approval from the Center for Medicare & Medicaid Services. CMS officials did not respond to requests

Helping seniors live at home longer

Expanded spousal impoverishment protection: Before receiving Medicaid assistance for nursing home care, individuals must first "spend down" their assets to an amount set by the state (essentially, impoverishment). However, home-dwelling spouses of

Democrats' budget goes to Gov. Christie

Democrats want to prevent the Medicaid cuts while tacking on millions more for school districts, women's health care and property tax relief. Christie's office Wednesday night would not say how he will pare the budget down to his liking.

How to Reduce Medicaid Spend Down Afford Long Term Nursing Home ...

Www.srplanners.com

Can you afford long term nursing home care?

Most people work hard all of their lives to accumulate sufficient assets to allow them to retire one day with (they hope) enough funds to see them through their remaining years. There are many dangers along this timeline that can derail our plans. One of the biggest dangers is the need for long term care at some distant point in the future, most likely nursing home care.

If long term care becomes necessary we can rely on Long Term Care Insurance (LTCI), if we purchased it back when we were in relatively good health. Even if you have LTCI, most policies provide coverage for only three to five years. Beyond that we must pay our own way if we still need care.

If we didn´t buy the LTCI, or if the benefit runs out, we must use our own assets to continue our care, or we can turn to the government. The government´s long term care plan is named Medicaid. Medicaid is available only after we have exhausted virtually ALL of our other assets. The process of exhausting our other assets is described as Medicaid Spend-Down. Medicaid primarily pays for nursing home care.

Relying on Medicaid to pay your nursing home care bills gets complicated quickly.

The calculations for Medicaid Spend-down are complicated, and cannot be covered in this short article. The “bottom line” is that in order to qualify for Medicaid the applicant must spend everything but $2,000 of their assets. Their homestead is protected – until they die. After their death the government can attach the homestead for repayment of the amount spent for their care. Additional exempt assets include one car, a burial plot, and a prepaid funeral.

In addition, the government takes all of the patient´s income but about $60 per month (indexed for inflation & varies by state), an allowance for personal care items. If the applicant is married, this process will be very unpleasant for the “well” spouse, as they will probably find themselves without sufficient resources for their own retirement needs if the Medicaid spouse dies first after spending away their assets. The well spouses are mostly widows, as men typically die first.