Tampa Bay Times editorial: Romney's lean, mean Medicaid plans for nursing home residents
http://www.tampabay.com/opinion/editorials/romneys-lean-mean-medicaid-plans-for-nursing-home-residents/1252778As the presidential campaign unfolds, the differences in approaches to Medicare by President Barack Obama and Republican nominee Mitt Romney have taken center stage. But what is getting far less scrutiny: Romney's plans for Medicaid. He would convert the health care program for the poor, disabled and elderly into a block grant to the states and sharply reduce funding over time. Middle-class Americans should be especially wary, since it's Medicaid, not Medicare, that covers nursing home care for aged and infirm parents and grandparents. Without Medicaid's safety net, it isn't clear what those Americans would do, and Romney doesn't have any good answers.
It's an understandable confusion. People think that since Medicare covers medical services for people over 65, it also pays for nursing home care for elderly people. Medicaid is thought of as a poverty program that provides medical coverage to poor families. But Medicaid is the program that provides long-term care to the elderly and disabled, which accounts for 31 percent of the program's $400 billion annual federal and state spending. Most of the nation's 1.8 million nursing home residents, including more than 77,000 Floridians, rely on Medicaid to pay their bills.
Medicaid's nursing home beneficiaries are not necessarily poor people. During their working years they may have lived productive middle-class lives until becoming infirm and quickly exhausting their assets. No matter how assiduously families save for retirement, there aren't many who could long afford the steep costs of a residential nursing home that can run an average of $80,000 a year. Without Medicaid's essential safety net, members of this vulnerable population would be on their own or might be forced to live with relatives ill equipped to care for their intensive needs.
There is an irony to Romney running mate Paul Ryan's applause line at the Republican National Convention last month that "the truest measure of any society is how it treats those who cannot defend or care for themselves." It was Ryan who authored the plan to convert Medicaid from a strong federal-state entitlement to a block grant program to the states that Romney has incorporated into his campaign. The plan, passed as a budget blueprint by the Republican-controlled House, would gut Medicaid's safety net and focus instead on cutting funds. The nonprofit Center for Budget and Policy Priorities says Medicaid funding would decline by one-third by 2022 under Ryan's plan.
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I agree with others who have said this article needs to be widely read and reprinted! All voters should read it or something akin to it before they vote in this election.
In 2006, after having my mother live with us for 3 years, we were no longer able to provide the kind of care she needed. She had Alzheimer's and assorted other medical problems a 92 year old woman might have. Shortly after our 3rd year of caring for her she suffered a gastric bleed and was sent home to us from the hospital without benefit of home health care or any other support. It only took us about 24 hours to realize what we were up against. So I went to our primary care physician (who had nothing to do with her hospitalization for the bleed) and got an immediate referral to home health care. That temporarily helped us until we were able to get her a referral to hospice care a couple of weeks later.
The hospice social worker made an assessment and through her, Mother was admitted to a nursing home. My mother had Social Security benefits, Medicare, a small annuity from her employment with the VA for 8 years as a nurse and Federal Blue Cross & blue Shield. She entered the nursing home under the MediCARE and it was to pay for her care for the first 20 days. After that she would have been enrolled in Florida MediCAID and her care would have continued without interruption or reduction of services. The social worker at the nursing home explained that since mother had no other assets to "spend down" her income (Social Security and Annuity) would be taken by the State for her care (except for a small amount each month to cover incidental expenses not covered by Medicaid) and the rest would be paid for by Medicaid. My husband and I were completely OK with this arrangement since there was no way on earth we could have absorbed the cost of her nursing home care without bankrupting ourselves or reducing ourselves into near poverty.
My mother, unfortunately, died two days later and so we never had the transfer to Medicaid. However, I have had other friends and acquaintances who told me that in their experience, the transfer would have been exactly as described by the nursing home social worker. The Romney Ryan plan is a nightmare in disguise for the elderly population living in the US. It is equally disastrous for those with disabled family members.
One thing about the way they are explaining their plan to the voters is the strategic use of Ryan's elderly Mother. He says that he would NEVER do anything to hurt his mother and I have no doubt he is telling the truth. What he DOES NOT tell us is that his mother likely would never need Medicaid since he is a wealthy (and upwardly mobile) man. She may even have long term care insurance, something that most Americans do not have and cannot afford. So while being truthful about what he plans to do for his own mother, he is dishonest in explaining to voters and it is a meaningless (and disingenuous) tactic to use his Mother as his example.
One last point....and on this one I am not absolutely positive about whether this is true....maybe someone on this board can tell me the answer. I have read that under Romney and Ryan's plan the CHILDREN or other relatives of an elderly person needing nursing home care could be held responsible for those nursing home costs if the person does not have the means to pay for it themselves. If that is the case, then the generations coming after the Baby Boomers (I am a boomer, born in 1948) better listen up and find out the details about this. Because if this is true, then THEY are going to be on the hook for the care of their parents and grandparents. (Maybe even aunts and uncles....) Yikes! 
America needs to hear your story along with others similar to yours.
Simply trying to explain these things is difficult without hearing from real people who have faced or are facing these issues.
How do we get stories like yours out there for the entire country to hear?
People must be able to apply the R/R plan to their own lives and lives of their family.
As the article stated, many people incorrectly ASSUME that Medicare will cover their nursing home costs. It does....but for only a limited amount of time. Say you are in the hospital and need a short time to get back on your feet. You can go to a nursing home for ...I think it's 20 days. After that, you're on your own, unless you have LONG TERM CARE or MediCAID to pick up the cost. If you have resources, depending on what those resources are, you may be held responsible for the cost.
Many of us who are seniors (and who are approaching those so-called "golden years"
need FACTS and simple explanations. Our children need this explained to them, too. If they will be the "next in line" to absorb the cost for mom and dad's nursing home bills, don't you think that they need to know what they are getting themselves in for if they vote for Romney-Ryan? If they STILL vote for those two, at least then they can't say they weren't warned!
