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8-3-04 Georgia Will Have Much Controversy Over Medicaid Recovery

Government and large company (less in future) retirees have good coverage.   However, this just widens the gap for those covered and not covered.   Something needs to be done to make health care and prescription drugs available at reasonable cost to all U S citizens.



August 3, 2004


Medicaid Recovery Program Will Be Political Hot Potato


By Wendell Dawson, Editor, AVOC, Inc.


Stories about the State’s policy changes on Medicaid continue to unfold.    Plans for  estate recovery and the complete disqualification of  many persons formerly covered because they marginally exceed the cut-off will not happen silently.


As a practicing attorney with estate planning experience, I know many families are touched by this problem.   Few persons can have enough resources to pay their medical expenses in full.  I really believe the Governor and Republicans in the legislature have underestimated the future fall-out from this situation.


Government and large company (less in future) retirees have good coverage.   However, this just widens the gap for those covered and not covered.   Something needs to be done to make health care and prescription drugs available at reasonable cost to all U S citizens.


Meanwhile, some adjustments (sliding scale as one) can be made to help with the Medicaid crisis in Georgia.  It is a crying shame to see Depression Era citizens go through their life savings because of a large hospital stay or extended nursing home stays.   It is even worse to take the family homes in such situations.   It is not right that some have full coverage (many are government retirees) and others have to lose everything to have medical coverage.


This is a crisis that cannot be swept under the rug.  It will haunt many elected officials for years to come.


The Macon Telegraph



August 1, 2004


Medicaid recipients could lose assets, property to state

Telegraph Staff Writer

Until recently, Pete Snider feared he and his wife would lose their family home to the state.  Snider and his wife, Vivian, who lives at Summerhill Nursing Home in Perry, receive Medicaid benefits.  Under a new state program, Snider and his wife, upon both of their deaths, could lose some money to the state as payback for Medicaid.  "When she passes away, and I pass away, then the state has the authority to come after our assets," Snider said.

Georgia is one of the last states to implement an estate-recovery program, in which the state tries to collect assets from the families of a deceased person who had received federal Medicaid benefits. The program affects anyone who stayed in a nursing home or received at-home care and had their coverage paid for or supplemented by Medicaid.

Thursday, the new policy officially becomes law. However, the state Department of Community Health has not yet decided the date the program will start.  Notices will be mailed to affected families, said agency spokeswoman Julie Kerlin.

From the state's perspective, the program is mandated by federal law and will bring in about $ million yearly - certainly a needed revenue boost at a time when the state is in the midst of an economic downturn.

But the program has been criticized by advocates for the elderly, including the AARP, Georgia Council on Aging and Georgia Nursing Home Association. The Georgia chapter of the AARP sent a letter Tuesday to Gov. Sonny Perdue scolding him for using Medicaid to balance the rest of the state's budget.   "It is the misfortune of the state's oldest, most infirm and economically disadvantaged residents to be caught in the cross hairs of your attempt to pick off parts of Medicaid under the guise of reform and balancing the budget," the AARP's letter said.

The implementation of the estate-recovery program, along with the elimination of Medicaid coverage for so-called medically needy patients who don't qualify for Medicaid coverage but have received it anyway has amounted to a double whammy on seniors, several advocates have said.   "(Both programs) have brought terrible emotional and traumatic changes to those that currently receive essential medical care in Georgia's long-term care settings," said Fred Watson, president of the Georgia Nursing Home Association. "The safety net and the lone pillar of health care funding is now being removed."

About 35,000 current nursing home residents face the loss of some assets, including real estate, to the state, Watson said.

Some advocates have described the estate-recovery program as a type of predatory loan - stealing money from the weak and vulnerable.  "I'm just outraged about it," said Conyers resident Martha Eaves, legislative chairwoman for the Georgia Council on Aging. "No other Medicaid program requires a payback."

Snider found out recently that the state decided against making the estate-recovery program retroactive to 2001. If that move had been approved, the will Snider had drawn up for himself and his wife would have made their family home an asset the state could claim. The Sniders had planned to give the home to Vivian Snider's son.  One way the state plans to recoup its Medicaid assets is filing a lien on real estate. While the Sniders are no longer in danger of losing their home, many other families affected by the estate-recovery program are vulnerable to losing real estate or other property.

The state delayed for years implementing the program which was approved by Congress in 1993, said Becky Kurtz, the state long-term care ombudsman. But only in the past couple of years, when the state's own finances declined, did health officials start putting it into effect.  "It's been a long time since the state has been this kind of budget situation," Kurtz said.

Too many people who will be affected by the program didn't know it was coming, and the state needs to do a better job of providing advance notice, Eaves said.  "People who go on the program need to know that it will occur," she said. "There are so many people who didn't know this was going to happen."

7-29-04 AARP Wades In On Medicaid and Gov. Perdue


The Atlanta Journal-Constitution July 27, 2004




AARP hits Perdue on care cuts

State axes assistance for 1,500


By Nancy  Badertscher

AARP Georgia, a potent lobbying force at the state Capitol for retirees, is lashing out at Gov. Sonny Perdue over plans to eliminate funding for some elderly nursing home patients and to go after the estates of others.

In a quarter-page ad scheduled to run in today's Atlanta Journal-Constitution, the organization writes in an open letter to Perdue: "These are not reforms, governor. They are a one-two punch to the solar plexuses of the frailest members of our dwindling 'Greatest Generation.' "

The ad asks the governor to "reconsider these drastic and damaging measures that, in the long run, will have little, if any, net effect on the state budget."

In a move to save an estimated $0 million, the state is eliminating a program that helps pay for nursing home care for about 1,500 people considered "medically needy" — meaning they have too much income to qualify for Medicaid, but not enough to afford private nursing home rates. State officials also are creating a program to recover some of the state's costs for long-term care services from the estates of Medicaid patients with assets of $5,000 or more.

Perdue spokeswoman Loretta Lepore said Tuesday the governor stands behind both changes. She said Perdue is "taking great pains to consider the needs of this population" and showed it when he granted a 90-day reprieve to participants in the medically needy program who were supposed to lose their benefits in July.

Democratic leaders, including Lt. Gov. Mark Taylor, have urged Perdue, a Republican, to reinstate funding for the program now that the state's fiscal situation is improving. The state finished the fiscal year last month with a small surplus.

The AARP says it has nearly 95,000 members in Georgia and has long been considered a political powerhouse in national debates on Medicare, Social Security and prescription drugs.

The group's letter says the governor, by eliminating the medically needy program, is hurting small public pension holders — such as teachers, firefighters, state workers and veterans — whose average age is 86. And it calls the estate recovery program "another blow to patients and families whose minuscule holdings represent what little stability they may have."

In the Department of Community Health, which oversees state Medicaid programs, Commissioner Tim Burgess said tough choices were thoroughly debated during the budget process this year. "If we're not going to spend as much money on Medicaid as we did last year, some people just don't get help," he said.

Department spokeswoman Julie Kerlin said participants in the medically needy program can put some of their money in trust accounts and retain their nursing home coverage.

That lowers their remaining income to a level under which they qualify for Medicaid. It's unclear how many are doing that, Kerlin said. She noted that states have been under a federal mandate since 1993 to set up estate recovery programs. Georgia and Michigan are the only states that don't have such programs.