URGENT Action Needed to Stop Severe Medicaid Changes!

Both houses of Congress have passed the most severe changes to Medicaid law in history. Due to a procedural matter, the House must vote once more on the bill when they reconvene. That vote could be as early as February 1, 2006.

The National Academy of Elder Law Attorneys, recognizing that Medicaid rules need to be simplified (reducing the need for lawyers) and government costs controlled, have given testimony proposing changes that will control costs while maintaining essential services for seniors and the disabled. (Some of these made it into an earlier Senate version of the bill.) Once these changes were enacted, it was then the hope of the Academy that Congress could consider a truly innovative proposal, such as a work-in-progress nicknamed the "New York Compact." That proposal would dramatically simplify the system and ensure everyone pays a substantial amount of their own funds.

Despite this, instead, Congress has seen fit to lash out at the Medicaid system with simplistic rule changes and insufficient thought given to the unintended consequences.

Current law imposes a disqualification period from receiving nursing home Medicaid if gifts were made within the past three years. Rather than explore the motives behind the gift, the rules boil down to this: the longer ago and the smaller the gift, the less the penalty. The bill before Congress disregards how long ago the gift was if within the past five years. If Mom paid a $7,000 tuition bill for a grandchild, shortly thereafter suffered a stroke, paid a nursing home privately for the next four and a half years, and then ran out of money, she would be disqualified from receiving Medicaid.

A few of the likely victims of these proposals are:

Under the proposals to tighten transfer of asset rules, each of these individuals will be denied Medicaid if they subsequently need long-term care.

Those who need nursing home care would not be able to gain entry. A nursing home is allowed to deny admission when there is no payment source. In cases where nursing home admission has already occurred and the penalty is applied, nursing homes will be required to provide uncompensated care for the duration of the penalty period or until hospitalization.

These proposals will create unacceptable new obstacles to nursing home admission for vulnerable, frail, elderly, and disabled persons to get care, by requiring record keeping and documentation that is far beyond the normal practices of the elderly, especially the poor, chronically ill, and those with Alzheimer's disease.

There are reasons for hope that this bill may be defeated. First, the vote was only 51-50 in the Senate (the Vice-President broke the tie) and 212-206 in the House. Also, many have woken up to the danger this bill poses, and are letting Congress know their opposition. For example, the nursing home industry is now opposed because they see that they will be the ones footing the bill when Medicaid won’t pay under the proposed rules.

Below is a sample letter you can use to let your Representative in Congress know where you stand. You can find how to contact your representative by visiting www.wheredoivotema.com (for Massachusetts residents) or www.house.gov/writerep for anywhere.

Thank you for making your voice heard.

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The Honorable [representative's name]
U.S. House of Representatives
Washington, D.C. 20515

Dear Representative [insert name]:

You and your colleagues in the House of Representatives will soon have another opportunity to consider the budget reconciliation bill (S. 1932, the Deficit Reduction Act of 2005). I am writing to request that you vote against the bill.

The bill contains changes to the Medicaid eligibility rules that will make it harder for seniors and disabled persons needing long-term care to qualify for Medicaid. The bill would: