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RoseRed135

"Obamacare" - should it stay or should it go?

128 posts in this topic

It seems the Affordable Care Act (ACA) or "Obamacare," as it's often called, is  going out once the new term begins. But President-Elect Trump has talked of keeping some parts of it - or, rather, "replacing" it w/ a plan that retains some parts. And while before, I saw complaints about the ACA on FB, now I'm seeing some people bemoaning the fact that any of it is going at all.

What do you think? Is the ACA a good thing or a bad one? Or are there some good segments to it that you feel should remain while others are discarded? Or... ??

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I am one of those that the ACA has helped with health insurance, or was going to help for this year.  Time will tell.

I retired 4 years ago, knowing that I would have 5 years before I qualified for Medicare, and that I would have to pay for my own insurance.  I could have been added to my DH policy from his work, but that would have been more expensive than Cobra.  I'm overweight, have a knee replacement and have a few other issues that are pre-existing.  The first year, I opted to pay for Cobra, while waiting for the ACA to start.   

When the ACA started, I wasn't eligible for any subsidy, due to our income, but was able to get an individual policy, thanks to the ACA and no pre-existing conditions.  But yes, it did have a high deductible.  The next two years, the deductible stayed the same, while the premiums increased.

This year, BCBS (that's I've had for probably most of my life) opted to drop individual policies. So back to shopping.  In our area, I had 2 options for insurance. I could get a different BCBS policy, same deductible, but an increase of about 60%, AND would be much more limited on what facilities I could use.
The 2nd choice was a different company, about the same deductible and rate, but a much larger service area.

Due to the ACA, and the fact that the premiums had skyrocketed, I was actually able to get some subsidy to help pay for my premiums.  With that help, it takes it back to what I was paying when I first retired.  

So, having said all of that, maybe it isn't the best, but for me, at least for now, it is helping.  I dread seeing what changes will be coming, since there appears to be no plan.   But I'm hoping that they keep the clause for pre-existing conditions, not only for me, but for all those with cancer, heart problems, diabetes,etc.

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We need to cut the crap and become a single-payer country, like every other developed, industrialized nation (and even like many backwards, third-world "developing" countries).

It is beyond disgusting how so many in this country can claim to be "pro-life," but they want to defund Planned Parenthood, throw out the ACA, and they continue to vote for a party that has NEVER done anything but fight against public health for the already-born.

I'm still enjoying a dark moment of hilarity, though, where this dummy on Facebook was crowing about how Trump was going to throw out "Obamacare." Someone said "Uh, don't you have health insurance through Obamacare?" And the guy said, "No, dummy, I'm not on Obamacare! I'm on the ACA!" This idiot didn't even realize the ACA IS Obamacare. As soon as he figured out his mistake (courtesy of everyone jeering at him), he fell quiet.

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8 minutes ago, oscarsmaman said:

We need to cut the crap and become a single-payer country, like every other developed, industrialized nation (and even like many backwards, third-world "developing" countries).

It is beyond disgusting how so many in this country can claim to be "pro-life," but they want to defund Planned Parenthood, throw out the ACA, and they continue to vote for a party that has NEVER done anything but fight against public health for the already-born.

I'm still enjoying a dark moment of hilarity, though, where this dummy on Facebook was crowing about how Trump was going to throw out "Obamacare." Someone said "Uh, don't you have health insurance through Obamacare?" And the guy said, "No, dummy, I'm not on Obamacare! I'm on the ACA!" This idiot didn't even realize the ACA IS Obamacare. As soon as he figured out his mistake (courtesy of everyone jeering at him), he fell quiet.

the problem I've seen is folks actually *believe* that Trump is going to keep the 'pre-existing' clauses and the keeping AC on parents insurance bits.

WHY do they believe that?

B/c he said so?

Well, first off, HE'S not the sole dominion here. And they've passed ammendments that will allow them to do away with precisely those issues.

Second, Trump has proven, time and again, that he lies, then denies lying, or simply shrugs. "Lock her up!" was a rallying cry. And then he announced, nope, not pursuing that. (I thought it was insane that he threatened to have a special prosecutor, etc to start with). Then there was the, "Build the wall, and Mexico's paying!" Oh, except, gee, we're gonna make the taxpayers cough up, but I super-dee-duper promise Mexico is gonna pay us back! And let us not forget the whole, 'Drain the swamp!' and yet, he's putting ppl who have heavily contributed to his campaigns, who have NO EXPERIENCE in cabinet positions. The Russians DIDN'T hack the election...oh wait, they did, but it had NO effect.

So, WHY, OH WHY does anyone think he's going to keep the bits of the ACA that they want/need? WHY does anyone actually believe there's another plan waiting in the wings?

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I like portions of Obamacare but not all of it- I wasn't on board with it to begin with, but because people kept saying that it would be a springboard to universal healthcare I supported it-

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My whole problem with Obamacare was it was pushed through without working out the detail (let's pass it and read it later per several politician).  There are some things about it that I like (being able to keep kids on policy, pre-existing conditions)  but there are a lot of things that either don't work as they should, have raised premiums/co pays/deductible sky high, caused people to loose doctors (that we were promised wouldn't happen), etc.  My monthly premiums went up 75% for an individual policy and has continued to rise by 25% each year since then.  My co-pay for my primary care doctor doubled.  My deductible doubled.  My co-pay for my specialists doubled.  I had to change several of my doctors because of the changes.  The only thing that went down for me was the cost of my perscriptions but that's because I started using mail order.  I wish before they had pushed this through they had actually read all the particulars and figured out how it worked/didn't work and tweak it.  Also once they realized how certain things weren't working that they fixed them.  I'm all for people having insurance but this doesn't mean people will buy it.  Many of my DDs friends just pay the penalty for not having insurance because it's cheaper than buying insurance. 

I hope that the new administration will come in and rework the plan.  Maybe add the ability for buying insurance across state lines.  I'm not sure I agree with universal healthcare either.  Something about the government being so involved with our healthcare when they can't even run the VA well scares the you know what out of me.  Not to mention knowing my most personal info and keeping it private/secure.  Not feeling they're able to do that.  But that's a different topic.

 

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As a self employed person, I like parts of Obamacare, such as the availability of insurance to people who don't work for an employer, as that was not a good system - connecting health insurance to an employer of a certain sized company or larger, because so many of us do not fall within that category.   I like being able to go online and select from different health care insurers and plans, as I did in the past when I was an employee for a large corporation.  I also like the ease in which health insurance is available.  I don't need to go to a broker or do a lot of calling around for quotes, rather I can get everything I need on one website which is easy to navigate. 

Just recently, my DH took a position with a company that offers medical benefits for him, me and the kids, but before that, he was self employed too, so our family was insured under Obamacare.  I thought the premiums were super high ($1,650 a month for our family of 5) for what amounted to major medical insurance.  Due to how high the deductibles and co-pays were, we held off on doctor visits, which I think is one problem with Obamacare - people end up not going to the doctor because it is too expensive even though they have insurance.  As a result, the goal of early intervention and diagnosis to save on health care costs associated with a late diagnosis is probably not being met with Obamacare.  When we had Obamacare, I could never make sense of the prescription co-pays.  They would vary monthly it seemed.  However, they were less expensive than what I am paying now under an employer sponsored health plan.  Fortunately, we never had a serious medical event during the time we were on Obamacare that would have required the deductible and co pays to be met, which would have been very costly. 

 

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When I worked for the surgical group, in addition to good coverage they funded an HSA (health savings account) to offset the cost of deductibles & copays. They are very forward thinking and overall good to their employees. When DH was diagnosed, one of the partners called me into his office to tell me that the company had "made an oversight" in funding my HSA, that the amount should be doubled because DH was on my plan....total BS, but  was floored at their generosity. So, even though we still had significant out-of-pocket for deductibles and such, it was still about 1/2 of what it could have been. After I was downsized out of a job, they let me keep the insurance at the company rate for several years and made it as easy as possible. DH's care often topped $30k a month, even if we spent $10k a year the savings was astronomic.

ACA for me is less than $200 a month. The annual deductible is steeper than I'd like, but so far everything I've done on it has been well care, so cost is zero. It's income based and I fall just a few dollars under the next level. Prescriptions are very low cost (except for that stupid inhaler), but I'll not need that often.

 

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8 hours ago, Mdgrandma said:

My whole problem with Obamacare was it was pushed through without working out the detail (let's pass it and read it later per several politician).  There are some things about it that I like (being able to keep kids on policy, pre-existing conditions)  but there are a lot of things that either don't work as they should, have raised premiums/co pays/deductible sky high, caused people to loose doctors (that we were promised wouldn't happen), etc.  My monthly premiums went up 75% for an individual policy and has continued to rise by 25% each year since then.  My co-pay for my primary care doctor doubled.  My deductible doubled.  My co-pay for my specialists doubled.  I had to change several of my doctors because of the changes.  The only thing that went down for me was the cost of my perscriptions but that's because I started using mail order.  I wish before they had pushed this through they had actually read all the particulars and figured out how it worked/didn't work and tweak it.  Also once they realized how certain things weren't working that they fixed them.  I'm all for people having insurance but this doesn't mean people will buy it.  Many of my DDs friends just pay the penalty for not having insurance because it's cheaper than buying insurance. 

I hope that the new administration will come in and rework the plan.  Maybe add the ability for buying insurance across state lines.  I'm not sure I agree with universal healthcare either.  Something about the government being so involved with our healthcare when they can't even run the VA well scares the you know what out of me.  Not to mention knowing my most personal info and keeping it private/secure.  Not feeling they're able to do that.  But that's a different topic.

 

We had Anthem when they were hacked- They now provide us with AllClear ID -- even though we have since switched providers-

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The federal government should not be in the insurance business.  We already have Medicare and Medicaid.  That is plenty and those (especially Medicaid) needs to to fixed.  have you ever sat down and figured out how much you (or we) pay in taxes, fees, etc.....I think when you add all of it up, most people are left with less than 50% of their income (make sure to add ALL taxes...federal, state, local, sales tax, property taxes, Medicare, medicaid, etc etc etc).  I wan't the government out of my life.  I don't have a problem with the Medicare so much because these people paid into it all their life. But because the government is in control, they have stolen it to fund whatever they decide is important (that's BOTH parties and they have been doing it forever), and they never pay it back.  Now they say there is no money for when those of us working will retire. Medicaid I believe should be a TEMPORARY help, unless someone is truly disabled.  Instead it is riddled with corruption and people who think they are "owed" this for some reason.  If the government wants to do something, fix those programs. They can't run these programs successfully, so they decide to branch out to force everyone to be on their programs. And of course it has failed miserably.  It's time to get the government out of our lives, not increase it... 

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1 hour ago, JustBreathe said:

The federal government should not be in the insurance business.  We already have Medicare and Medicaid.  That is plenty and those (especially Medicaid) needs to to fixed.  have you ever sat down and figured out how much you (or we) pay in taxes, fees, etc.....I think when you add all of it up, most people are left with less than 50% of their income (make sure to add ALL taxes...federal, state, local, sales tax, property taxes, Medicare, medicaid, etc etc etc).  I wan't the government out of my life.  I don't have a problem with the Medicare so much because these people paid into it all their life. But because the government is in control, they have stolen it to fund whatever they decide is important (that's BOTH parties and they have been doing it forever), and they never pay it back.  Now they say there is no money for when those of us working will retire. Medicaid I believe should be a TEMPORARY help, unless someone is truly disabled.  Instead it is riddled with corruption and people who think they are "owed" this for some reason.  If the government wants to do something, fix those programs. They can't run these programs successfully, so they decide to branch out to force everyone to be on their programs. And of course it has failed miserably.  It's time to get the government out of our lives, not increase it... 

Here's the thing that's always baffled me: folks in the US have an *incredible* amount of interference in their health care choices, from what I've seen, from their insurance companies. If my Dr says I need a test, a specialist, a treatment, I get it. There's nobody saying I can't, I'm not eligible. I have many American friends who've been told that no, they can't see that specialist, no, they can't do that, b/c it's not covered.

To me, that's mind blowing.

I also find the idea that you somehow have to *earn* the right to health care. "Sorry, you go off and die, b/c you don't have enough money." I really don't get how that's a reasonable stance.

As for the financial aspect? I compared deductions from paycheques w/a friend in the US. I paid less in TOTAL than she did just for insurance. That's not looking at all the other taxes, copays, etc.

I really don't understand why health care is only for the financially able. Not in a first world country.

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3 hours ago, ImpishMom said:

Here's the thing that's always baffled me: folks in the US have an *incredible* amount of interference in their health care choices, from what I've seen, from their insurance companies. If my Dr says I need a test, a specialist, a treatment, I get it. There's nobody saying I can't, I'm not eligible. I have many American friends who've been told that no, they can't see that specialist, no, they can't do that, b/c it's not covered.

To me, that's mind blowing.

I also find the idea that you somehow have to *earn* the right to health care. "Sorry, you go off and die, b/c you don't have enough money." I really don't get how that's a reasonable stance.

As for the financial aspect? I compared deductions from paycheques w/a friend in the US. I paid less in TOTAL than she did just for insurance. That's not looking at all the other taxes, copays, etc.

I really don't understand why health care is only for the financially able. Not in a first world country.

Amen!

But technically, nobody has to crawl off and die. There are clinics, some free, some charge small fees. Most of the work is volunteer.  However, they are far and few between.  Also, hospitals are required by law to provide care to people, they cannot turn people away from Emergency Rooms.

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And .. and if a person cannot afford the ER bill, they can apply for charity care thru the hospital, which covers most of the bill .. But .. but one would have to be living below the poverty line income wise numbers in order to apply ..

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In other words, be homeless or darn close ..

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3 hours ago, Komorebi said:

In other words, be homeless or darn close ..

I had a coworker whose FIL owned a farm.  She felt entitled to own that farm once he passed away and was highly offended that he was required to use some of those farm assets to pay for his own medical care.  IMO that meant that she felt that I the taxpayer should pay for his health care  (yes he paid into Medicare but it doesn't cover everything)  and she should reap the benefits.  So yes, in your line of thinking  I guess that means I think he need to be homeless. 

EXCEPT  I'd like to point out, that his farm is only taken away from him or his spouse after BOTh of them are dead.   The only person ho is really homeless is the DIL who IMO is not entitled to that farm anyway.

\My co worker is the most liberal person I know and even she thinks this is the way it should be.

You want universal health care.  I may be on board with it.  But only if there  is NO opt outs. Every one pays as much as they can from day one.  You can't wait until you are ill and then suddenly want in on the good deal that wasn't so good when you were well.

 

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35 minutes ago, skipped said:

I had a coworker whose FIL owned a farm.  She felt entitled to own that farm once he passed away and was highly offended that he was required to use some of those farm assets to pay for his own medical care.  IMO that meant that she felt that I the taxpayer should pay for his health care  (yes he paid into Medicare but it doesn't cover everything)  and she should reap the benefits.  So yes, in your line of thinking  I guess that means I think he need to be homeless. 

EXCEPT  I'd like to point out, that his farm is only taken away from him or his spouse after BOTh of them are dead.   The only person ho is really homeless is the DIL who IMO is not entitled to that farm anyway.

\My co worker is the most liberal person I know and even she thinks this is the way it should be.

You want universal health care.  I may be on board with it.  But only if there  is NO opt outs. Every one pays as much as they can from day one.  You can't wait until you are ill and then suddenly want in on the good deal that wasn't so good when you were well.

 

Your coworker, she probably contributed- :)  She probably didn't opt out- Unless she's fantastic at financial planning?  My line of thinking is .. people put more into Medicare, and health insurance in general, than they get out of it- It's a profitable industry, and somebodies, somewhere, is benefiting from the profits .. somewhere in Costa Rica, sipping rum or other stuff on a white sand beach .. :) .. So, sure- I can see how your friend, somehow, for some reason, feels entitled to the farm- No different than the people on the white sand beach felt entitled to profits .. :) 

 

 

And .. AND we all seem to be OK with the white sand people profiting -- business as usual!

Edited by Komorebi

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Farms around here aren't cheap.  I'm sure if coworker did inheret the farm, she could sell and the profits easily buy a nice home somewhere in Costa Rica, sip on rum on white sand beach  Around here farmers may not be rich, but their farms are worth a LOT of money.  Guessing  well over a million.

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Farmers around here may own their "home place" but others are probably leased on a share basis or even cash per acre.  Farming is a business and a large investment.  A new tractor can cost more than a really nice home.  Just because someone owns a piece of land doesn't make them rich. 

Most farmers wives around here have jobs where they can buy "group insurance" because self employed insurance is high.  Farming is one of the most dangerous occupations.  A farmer without insurance is living on the edge.

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I agree- With Sue- :)  Farming isn't a highly profitable industry -- considering if a farmer has a bad year, and all they stand to loose-

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7 hours ago, skipped said:

I had a coworker whose FIL owned a farm.  She felt entitled to own that farm once he passed away and was highly offended that he was required to use some of those farm assets to pay for his own medical care.  IMO that meant that she felt that I the taxpayer should pay for his health care  (yes he paid into Medicare but it doesn't cover everything)  and she should reap the benefits

Skipped is correct. Lots of people prefer to transfer the cost of medical care to the US taxpayers vs divesting their own assets (such as farms). It's legal to do while following very specific rules.
 
For example: A person needs/wants to spend their assets down to the medicaid limit (2k) before going into assisted living, works well in states that accept medicaid for AL expenses IF one believes in spend down. We have clients who do want to spend down.
 
We advise people who want to "help family spend down for medicaid" (while caring for a person) to make sure they cover all care/needs and then take a "salary" for managing care, pay for "miles" using IRS business rate for driving to medical appointments, shopping, errands. Pay "room" expenses to themself at IRS (business expense type) rates and calculations for the utilities, insurance, taxes, mortgage or rent on the bedroom and other rooms used (1 bedroom, kitchen and living room out of an 8 room home, for example, no counting bathrooms and laundry or basement). Adding as many expenses as one can justify (including salary). It's all legit, though not nice to fellow taxpayers.
 
Last I helped a client, $4500/ mo was the amount of assets that could be spent/transferred out before the "look-back" rule about hiding assets would apply. No rules impact what the $4500/mo can be spent on: food, clothes, lotto tickets, vacations, maids, visa bills, anything.
 
That said, one can't transfer excess assets (over the $4500/mo) to other folks, except with very specific reasons/limits/relarionships or the "look-back" rules will apply for 5 years, to protect the government and medicaid funds from fraud. Needed/justified care is not capped, to be clear. But one can spend/divest (on other than care) only about $4500/mo without risking scrutiny and government "look-back".
 
I personally am not in favor of "spending down" but I don't write medicaid rules and policy.

 

Edited by JanelleK
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11 hours ago, skipped said:

.

You want universal health care.  I may be on board with it.  But only if there  is NO opt outs. Every one pays as much as they can from day one.  You can't wait until you are ill and then suddenly want in on the good deal that wasn't so good when you were well.

 

Hmmm... just like w/ public education - everyone pays, whether they have a child in the public schools or not. Otherwise, public education wouldn't be available to those/when you (general) and yours need it.

But that reminds me of one of the gripes I've heard about the ACA - the fact that people are required to have health insurance if they can afford it. Not as big a complaint as those about rising premiums, etc., but a complaint I've heard a few people make. Their feeling, as I understand it, is that it should be a choice.  IDK how widespread this attitude is or how it would impact, if at all, the implementation of a universal health care system here in the U.S.

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On January 19, 2017 at 7:56 AM, JustBreathe said:

The federal government should not be in the insurance business.  We already have Medicare and Medicaid.  That is plenty and those (especially Medicaid) needs to to fixed.  have you ever sat down and figured out how much you (or we) pay in taxes, fees, etc.....I think when you add all of it up, most people are left with less than 50% of their income (make sure to add ALL taxes...federal, state, local, sales tax, property taxes, Medicare, medicaid, etc etc etc).  I wan't the government out of my life.  I don't have a problem with the Medicare so much because these people paid into it all their life. But because the government is in control, they have stolen it to fund whatever they decide is important (that's BOTH parties and they have been doing it forever), and they never pay it back.  Now they say there is no money for when those of us working will retire. Medicaid I believe should be a TEMPORARY help, unless someone is truly disabled.  Instead it is riddled with corruption and people who think they are "owed" this for some reason.  If the government wants to do something, fix those programs. They can't run these programs successfully, so they decide to branch out to force everyone to be on their programs. And of course it has failed miserably.  It's time to get the government out of our lives, not increase it... 

If you want the government out of your life, you need to find an island somewhere and put in your own infrastructure.

I am beyond tired of people slagging our government while driving on our roads, eating FDA-regulated food, breathing EPA-regulated air, listening to FCC-regulated radio, and best of all, slagging the government on the government-created Internet.

Some of the best things we have in this life are given to us or regulated by the government that WE pay taxes to in order to support a higher standard of living.

And it's not just Medicare and Medicaid the government provides. They offer a lot of R&D, the CDA, CPS, Planned Parenthood, special programs for Native Americans, AND.....the VA. 

I'm sorry, but we're overdue for government-run healthcare and most of all, price controls which work marvelously in other countries. America's economy should not depend on making its populace sicker rather than healthier.

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15 hours ago, RoseRed135 said:

Hmmm... just like w/ public education - everyone pays, whether they have a child in the public schools or not. Otherwise, public education wouldn't be available to those/when you (general) and yours need it.

But that reminds me of one of the gripes I've heard about the ACA - the fact that people are required to have health insurance if they can afford it. Not as big a complaint as those about rising premiums, etc., but a complaint I've heard a few people make. Their feeling, as I understand it, is that it should be a choice.  IDK how widespread this attitude is or how it would impact, if at all, the implementation of a universal health care system here in the U.S.

Neither do I .. but it would be nice to see everyone covered-

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3 hours ago, oscarsmaman said:

If you want the government out of your life, you need to find an island somewhere and put in your own infrastructure.

I am beyond tired of people slagging our government while driving on our roads, eating FDA-regulated food, breathing EPA-regulated air, listening to FCC-regulated radio, and best of all, slagging the government on the government-created Internet.

Some of the best things we have in this life are given to us or regulated by the government that WE pay taxes to in order to support a higher standard of living.

And it's not just Medicare and Medicaid the government provides. They offer a lot of R&D, the CDA, CPS, Planned Parenthood, special programs for Native Americans, AND.....the VA. 

I'm sorry, but we're overdue for government-run healthcare and most of all, price controls which work marvelously in other countries. America's economy should not depend on making its populace sicker rather than healthier.

I agree-

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20 hours ago, JanelleK said:
Skipped is correct. Lots of people prefer to transfer the cost of medical care to the US taxpayers vs divesting their own assets (such as farms). It's legal to do while following very specific rules.
 
For example: A person needs/wants to spend their assets down to the medicaid limit (2k) before going into assisted living, works well in states that accept medicaid for AL expenses IF one believes in spend down. We have clients who do want to spend down.
 
We advise people who want to "help family spend down for medicaid" (while caring for a person) to make sure they cover all care/needs and then take a "salary" for managing care, pay for "miles" using IRS business rate for driving to medical appointments, shopping, errands. Pay "room" expenses to themself at IRS (business expense type) rates and calculations for the utilities, insurance, taxes, mortgage or rent on the bedroom and other rooms used (1 bedroom, kitchen and living room out of an 8 room home, for example, no counting bathrooms and laundry or basement). Adding as many expenses as one can justify (including salary). It's all legit, though not nice to fellow taxpayers.
 
Last I helped a client, $4500/ mo was the amount of assets that could be spent/transferred out before the "look-back" rule about hiding assets would apply. No rules impact what the $4500/mo can be spent on: food, clothes, lotto tickets, vacations, maids, visa bills, anything.
 
That said, one can't transfer excess assets (over the $4500/mo) to other folks, except with very specific reasons/limits/relarionships or the "look-back" rules will apply for 5 years, to protect the government and medicaid funds from fraud. Needed/justified care is not capped, to be clear. But one can spend/divest (on other than care) only about $4500/mo without risking scrutiny and government "look-back".
 
I personally am not in favor of "spending down" but I don't write medicaid rules and policy.

 

Thank you, Janelle- Great post!

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