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Congress Considers Making it Harder for Seniors to Qualify for Medicaid

According to a recent Forbes article, Congress is considering a proposal that might make it harder for some seniors to qualify long-term care benefits through the Medicaid program. Under this proposal, some seniors would receive significantly greater long-term care benefits under Medicaid, but other seniors could lose out on long-term care benefits if Congress chooses to eliminate the use of spousal annuities as a Medicaid eligibility strategy.

The House Energy and Commerce Committee has begun what is likely to be a highly contentious and lengthy debate about which groups of seniors are entitled to long-term benefits under the Medicaid program. The overall goal of this Republican-led committee is to eliminate or drastically reduce Medicaid long-term care benefits for those groups whom the committee believes are undeserving of the benefits, while boosting long-term care benefits for those whom the committee believes are worth of the benefit.

The GOP plan reportedly is to cap the federal contributions to the Medicaid program by using a block grant system. Currently, both the federal government and the states financially support the Medicaid program. A block grant system would redistribute the limited federal funds for Medicaid to the states, rather than continuing to increase federal contributions to and support of the program.

The most controversial part of the GOP proposal is to prevent married couples from using spousal annuities as a means of reducing their income and assets in order to more quickly qualify for long-term care coverage under Medicaid. Currently, when one spouse is residing in a nursing home, the spouse who is still living at home, or the community spouse, is allowed to retain separate assets to support his or her costs of daily living. Purchasing a spousal annuity is one way for the spouse who needs long-term care to reduce his or her own assets to a level that makes him or her eligible for Medicaid, while still maximizing the community spouse’s income. This is common long-term care planning strategy that is designed to qualify an individual for Medicaid’s long-term care benefits more quickly, particularly in the case of lower-income couples, who are the primary Medicaid beneficiaries. Under the proposed bill, however, half of the community spouse’s annuity income would count as a resource for the spouse who needs long-term care. In other words, for couples in this situation, it would not be only more difficult to qualify for Medicaid long-term care benefits, but it would take much longer for the spouse needing the benefits to qualify for Medicaid coverage.

Whether your loved one has Medicaid coverage or not, choosing between long-term care facilities and in-home care can be a difficult decision. It is hard to determine not only what level of care is appropriate and ensure quality of care, but also to fund long-term care; Medicaid can be an integral part of funding that care. If in-home senior care or long-term facility care should lead to abuse, injuries, or theft, you may have legal grounds for a lawsuit against the individual and agency that caused the abuse or neglect. If you or a loved one is in this situation, you should definitely contact an experienced Wisconsin elder abuse and neglect attorney at Boller & Vaughan. We know how to protect your rights and potentially get you compensation for any injuries that occurred. When professional caregivers fail to meet the duty of care owed to you or your loved one, it is up to you to hold negligent Wisconsin home health care agencies responsible for their actions. Call Boller & Vaughan today and see what assistance we can offer you and your family.