The Medicaid Long-Term Care Reform Act of 2012

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[FONT="Times New Roman","serif"]LTC Bullet: [/FONT]​
[FONT="Times New Roman","serif"]The Medicaid Long-TermCare Reform Act of 2012[/FONT]
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Friday, October 5, 2012

[FONT="Times New Roman","serif"]LTC BULLET: THE MEDICAID LONG-TERMCARE REFORM ACT OF 2012[/FONT]

[FONT="Times New Roman","serif"]LTC Comment: Congressman Charles W.Boustany, Jr., MD (R, LA) introduced the Medicaid Long-Term Care Reform Act of2012 (H.R. 6300) on August 2, 2012. This legislation advances the cause ofresponsible LTC planning and rational LTC public policy. Co-sponsors areGingrey, Blackburn, Tiberi and Westmoreland. The short description of H.R. 6300and the full text can be found on [/FONT][FONT="Times New Roman","serif"]http://thomas.loc.gov[/FONT][FONT="Times New Roman","serif"]. A few of its major featuresfollow. [/FONT]
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  • [FONT="Times New Roman","serif"]Sense of Congress resolution to repeal CLASS, discourage middle class dependency on Medicaid, encourage private LTC insurance, educate the public about LTC planning, improve the LTC Partnership program, and allow states to target Medicaid to the most needy.[/FONT][FONT="Times New Roman","serif"][/FONT]
  • [FONT="Times New Roman","serif"]Compels the HHS Secretary to provide technical assistance to states on LTC Partnerships and Medicaid estate recoveries.[/FONT][FONT="Times New Roman","serif"][/FONT]
  • [FONT="Times New Roman","serif"]Requires the National Clearinghouse for LTC Information to increase the number of middle class people who receive information about the limitations of Medicaid and Medicare and the alternatives for private LTC financing.[/FONT][FONT="Times New Roman","serif"][/FONT]
  • [FONT="Times New Roman","serif"]Directs the HHS Secretary to evaluate ways to . . .[/FONT][FONT="Times New Roman","serif"][/FONT]
[FONT="Times New Roman","serif"]1. Expand LTC insurance coverage [/FONT]

[FONT="Times New Roman","serif"]2. Solicit ideas from listed stakeholders on ways toreduce state and federal Medicaid expenditures[/FONT]

[FONT="Times New Roman","serif"]3. Consider block granting Medicaid LTC[/FONT]

[FONT="Times New Roman","serif"]4. Study the effectiveness of Medicaid asseteligibility rules, estate recovery, and transfer of assets penalties.[/FONT]

[FONT="Times New Roman","serif"]5. Ascertain potential savings from policy optionsevaluated.[/FONT]

  • [FONT="Times New Roman","serif"]Requires the HHS Secretary to report to Congress no later than January 1, 2014 with recommendations based on the policy options considered in the preceding reviews.[/FONT][FONT="Times New Roman","serif"][/FONT]
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  • [FONT="Times New Roman","serif"]Requires the Secretary to consult with a list of experts including the Center for LTC Reform.[/FONT][FONT="Times New Roman","serif"][/FONT]
  • [FONT="Times New Roman","serif"]Mandates the Director of the Congressional Budget Office to report on . . . [/FONT]
[FONT="Times New Roman","serif"]1. The percentage of middle class people who will rely in the next 20years on Medicaid for LTC services compared to the percentage that will relysolely on private financing from savings, home equity or insurance. [/FONT]

[FONT="Times New Roman","serif"]2. The cost of such reliance on Medicaid.[/FONT]

[FONT="Times New Roman","serif"]3. The likely impact of potential policy options such as reducingMedicaid’s home equity exemption to $200,000 or $50,000; extending the transferof assets look back period to 10 years; expanding the use of liens to preserveproperty for later estate recovery; and allowing LTC insurance to be includedin employer “cafeteria plans.”[/FONT]

[FONT="Times New Roman","serif"]4. The potential savings from such policy options if Medicaid were blockgranted to the states.[/FONT]

  • [FONT="Times New Roman","serif"]Precludes any proposal that requires the enrollment of individuals in a specific program or insurance product.[/FONT][FONT="Times New Roman","serif"][/FONT]
[FONT="Times New Roman","serif"]What do our nation’s Governors thinkof the Medicaid Long-Term Care Reform Act’s objectives? That’s what the bill’ssponsors seek to find out in a letter mailed to Governors on September 14,2012, a sample of which we’ve provided below. [/FONT]

[FONT="Times New Roman","serif"]After laying out some facts andprinciples about Medicaid and long-term care financing, the letter asksGovernors these questions:[/FONT]

  • [FONT="Times New Roman","serif"]Should the federal government give states greater flexibility to consider assets, including substantial home equity, when determining eligibility for long-term care coverage through the Medicaid program? Why or why not?[/FONT][FONT="Times New Roman","serif"][/FONT]
  • [FONT="Times New Roman","serif"]Please provide examples of barriers to effective Medicaid estate recovery programs and tools that might help states in this area.[/FONT][FONT="Times New Roman","serif"][/FONT]
  • [FONT="Times New Roman","serif"]Should state and federal governments encourage middle-income Americans to anticipate and plan for their future long-term care needs, instead of relying on Medicaid, a safety net for the poor? Why or why not?[/FONT][FONT="Times New Roman","serif"][/FONT]
  • [FONT="Times New Roman","serif"]Do you consider Medicaid estate planning to be a significant problem that takes resources from the truly needy in your state? Please explain and provide examples.[/FONT][FONT="Times New Roman","serif"][/FONT]
[FONT="Times New Roman","serif"]Interested in your Governor’s reply?Why not forward this LTC Bullet to him or her and ask? You can find alist of the Governors’ email addresses here: [/FONT][FONT="Times New Roman","serif"]http://www.conservativeusa.org/mega-cong.htm[/FONT][FONT="Times New Roman","serif"]. [/FONT]

[FONT="Times New Roman","serif"]Who can object to saving Medicaidfor those in need? Certainly not advocates on the left who represent the poor.Not financial conservatives on the right who seek fiscal responsibility.Targeting Medicaid’s scarce LTC resources to people in need and encouragingothers to plan responsibly for long-term care just makes objective sense,regardless of one’s political orientation or ideology.[/FONT]
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