A Painful Conundrum - The Hidden Tax Trap
By Rosemarie Jackowski
07 March, 2014
Countercurrents.org
This makes the Banking Mortgage Fraud scandal look like child's play. In either case, families lose their homes. Stated very simply, Medicaid is now a loan program. Low income citizens need to have this information. They need to be told that they have been singled out to re-pay health care expenses. Poverty has now been institutionalized and will pass from one generation to the next.
The issue that needs to be examined is the 'claw back' provision of ACA Medicaid. This is sometimes referred to as 'estate recovery'. That term gives a misleading impression when applied to the very poor. Poor people do not have ' estates '. Sometimes a poor family has a home, but that is just about it.
Those who are dirt poor will now even have their dirt - the family home and the land it stands on - taxed away from any heirs. Of course, those with accountants, lawyers, and financial planners may find a way to avoid this unfair tax, but poor families do not have that kind of support system.
Unfortunately, even many legislators and health care navigators are not aware of the new problem with ACA Medicaid. 'Estate recovery' has been included in the law since 1993 - but the new problem is that it has been expanded under ObamaCare. This provision in the law is punitive and prejudicial. It will be imposed only on the poor - those who qualify for Medicaid. This is a death tax only on those with low or no income.
Here is an example of what some applicants have been told to sign in order to get Medicaid. This looks like a blank check to the government.
"... If anyone on this application enrolls in Medicaid, I am giving the Medicaid agency our rights to pursue and get ANY MONEY from other health insurance, legal settlements, OR OTHER THIRD PARTIES . I am also giving to the Medicaid agency rights to pursue and get medical support from a spouse or parent."
We need truth and transparency. Everyone should think hard before signing the Medicaid consent form. It is like signing a blank check. The government will be authorized to come after children and grandchildren for any property left to them by the Medicaid recipient. This is a hidden tax trap on poor families. Poverty has now been institutionalized and it will be passed from one generation to the next.
Will poor unmarried citizens be 'penalized' for their low income and also for not having a spouse? Marriage might offer protection. Some people have gotten married to escape some of the punitive provisions of the law.
Oregon officials have taken action to minimize the problem. It will be helpful if legislators in other states take corrective action. If they don't - decisions will be made by nameless, faceless, anonymous bureaucrats who can never be held responsible for their decisions. Silent, voiceless, disenfranchised citizens will be victimized.
Seattle Times - December 15, 2013: "...In Oregon, state officials changed estate-recovery rules last month. Recovery will no longer apply to health benefits for those 55 and over, the Oregon Health Authority said, although the state will collect expenses for long-term care...".
How many other surprises are hidden in the new law and the old law? In the past, Medicaid had a 'claw back' provision which was usually applied only to long-term care. Now, if ACA expands the 'claw back' provision, increasing numbers of families will be affected. Those few who know about the 'claw back' provision are searching for a way to opt-out of Medicaid. Apparently there is no legal way to opt-out. Some applicants have been told they cannot opt-out of Medicaid. The question is: Can they refuse to opt-in. What will happen to those who refuse to sign the documents?
Part of the problem is that the laws around health care are too complex. No one understands them. The Ten Commandments can be written on an index card. The original copy of the US Constitution was 4 pages. It has been reported that the law providing for the Canadian Health Care system was 14 pages - as compared to the more than 2000 pages for ACA. To further complicate the issue - every state has different rules. Provisions of ACA will be argued in the Courts for many years. Funding that should be used for medical care will go toward legal battles. Any law that is more than a few pages is filled with loop-holes and legal ambiguities. We need to change the way laws are written, but that is another topic.
From the Senator McConnell Facebook page :
"Just take a look at this giant stack: one day's worth of ObamaCare regulations. 828 pages in one day. Overall, there are nearly 20,000 pages – with many, many more to come. This is the owner's manual for the health care law that's supposed to make things better. Are you kidding? This law is a disaster waiting to happen...".
How can this be fixed? For starters, maybe all citizens should be treated exactly the same. That would require a system such as Single Payer. Any system which has various groups, different plans, separate classes of patients based on age, income etc. is sure to be unfair to some. We also need to control cost, cap hospital CEO compensation, and control the cost of pharmaceuticals. In addition, we need paper work reduction. Increasing the number of paper churners and IT consultants does not improve the quality of health care. Any money diverted from direct care should be carefully scrutinized. In the meantime, people need medical care now - today. If necessary, set up community clinics immediately.
It goes without saying, we need to get the insurance companies out of health care. Health care for profit will never be affordable. And we need to get politics out of health care. State and Federal officials need to step up and do the right thing. Partisan politics in health care is a violation of the most fundamental ethics.
Setting up all of the various state IT systems has cost a fortune. Has that money been wasted? We paid for an army of 'experts' and 'consultants', but the results have been disappointing. However, the major flaw is not a technical glitch. The law itself is flawed. It is a disaster that has already started to surface in many places around the country.
Some low income people are now considering going without any health care. They are forced to choose between leaving some equity in the family home to their loved ones, or having health care for themselves. What a painful conundrum. ACA Medicaid has created a class of citizens who will be excluded - unless they sign on the dotted line. How did things get this bad?
Why do so few know about this? Many respected sources have been sending out the warning. Paul Craig Roberts' article titled "Obamacare - Final Payment - Raiding Assets of Low Income Poor Americans" is available on the Internet.
Rosemarie Jackowski is an Advocacy Journalist. She is author of BANNED IN VERMONT.
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