‘Well-to-Do’ Should Stop Using Medicaid to Cover Nursing Home Care, Columnist Says

Although Medicaid programs are "supposedly for the poor," they are "being exploited" by middle- and upper-middle class individuals who shift and conceal their assets to qualify for government assistance with health bills, syndicated columnist Jane Bryant Quinn writes in a Nashua Telegraph op-ed. Quinn writes that some "well-to-do" people who are "willing to take care of themselves as long as they maintain their health" quickly look for government assistance once they face the prospect of paying nursing home bills. "They look for ways of leaving their own money to their children, while forcing the taxpayer to provide their care," Quinn states. She adds that even though these maneuvers are "unethical," they are legal, since many state laws concerning Medicaid eligibility "conceal many weak points that let moneyed people onto the rolls." Through one such "loophole," the spouse of a nursing home resident can acquire that person's assets and then refuse to pay for medical care, leaving the resident to be covered by Medicaid. Although the state can sue the healthy spouse to recover the money, such action is "not frequent," she writes. Other maneuvers include diverting assets into investments in a small business or farm or into an annuity, Quinn says. Tactics such as these, combined with the aging of the population, could cause Medicaid spending to "easily lurch out of control ... unless it's limited to the people who really need it," Quinn states, concluding, "The more people with money exploit the system by not paying for themselves, the worse the care is going to be for everyone" (Quinn, Nashua Telegraph, 5/29).