Medicaid rules changed when President Barack Obama pushed through the Affordable Car Act (ACA) and he ensured that the very rich could join low-cost Medicaid, while the working class had to pay high medical expenses, either at work with private insurance or retired under Medicare.
While I’m sure Jeff Bezos would never stoop his mightiness to rub elbows with regular folks on Medicaid, it is amazing that he could so by following these steps:
- Convert all $140,000,000,000 of his wealth holdings into cash, real estate, yachts, gold, silver, the most expensive autos.
- He then would only withdraw cash for his needs. He owns enough to take out $5,479,452 a day for the next 70 years. And with his owner’s discount at Amazon and Whole Foods, plus a free subscription to the Washington Post, Bezos will get by under this financial plan.
The good news is that under Medicaid, Jeff will only have to pay $4 for each physician visit or physical therapy session. Preferred drugs will cost $4, and non-preferred (like my $426 a month Xarelto) will only set him back $8.
And there’s more, including virtually free dental, hearing aids, and eyeglasses.
Want to visit the Emergency Room? That will cost $8, and we wonder why those rooms are crowded with folks who should be visiting their family doctor instead, but don’t make the effort or won’t wait for an appointment.
Unfortunately for Bezos, Medicaid doesn’t cover visits to the Hair Club for Billionaires, but now – more and more – it will fully cover procedures like gender reassignment surgery and hormone therapy that usually costs $30,000 to $40,000. If desired Jeff would only have to pay Medicaid’s co-pay of $75 for the entire hospital stay and choice of wig.
If you are not Jeff Bezos and you work to earn anywhere near the median annual income of $31,000, you can’t receive Medicaid in any state – even if you are homeless, don’t have a dime in the bank, or a chicken in your pot.
What did Obama and the Congress do to create this stupid system?
The ACA was drafted by experts from the greedy insurance industry, outnumbering some well-meaning intellectuals, who were most concerned with including anyone who needed a helping hand.
Obama’s first step was to increase the income level for Medicaid eligibility from $12,140 to 133% of that total in some states, and 150% in others. This expanded the pool to create an enrollment today of 74,000,000 persons – nearly one in five of all Americans.
For decades, Medicaid required you have less than $2,000 in resources (money in checking or savings, real estate, etc.) That requirement was totally eliminated by the ACA.
Today, it’s okay for a billionaire to own five homes and pay $8 for their Xarelto blood thinner monthly prescription. Meanwhile, the uninsured $8-an-hour cleaning lady – on the same drug – pays $426.
Most of the best benefits of the ACA end when you reach 65 – working or not. The law requires you to then go on Medicare or private equivalent. That results in average per person co-pays and premiums of $5,496 a year if in good health, and $9,576 in poor health – a far cry from Medicaid’s no premiums and $4 visits to the doctor.
Saddest of all, the asset test for Medicaid was not dropped for seniors who must be confined to nursing homes (40% of all residents). These homes charge an exorbitant average of about $94,000 a year.
If you are single and your assets exceed only a measly $2,000, you are not eligible for Medicaid nursing home subsidy. You must pay the full list price of the facility until you run out of assets and fall to that impoverished $2,000 total:
- Bank accounts, IRAs, stocks, jewelry and cash: Your first $2,000 is yours. Medicaid will count any dollars above this amount against you. For example, if you have $3,500 in your bank account, $1,500 will count toward reaching your Medicaid asset limit.
- Funeral and burial funds: Funds used to arrange a future funeral or memorial are excluded from your Medicaid assets. This includes burial plots, not only for you, but your immediate family. If no preparations are made in advance, only a bank account up to $1,500 can be reserved for funeral expenses. Everything above that is counted towards your Medicaid qualifying $2,000 assets limit
- Insurance policies: Medicaid will include the cash value of a life insurance policy over $1,500 in their asset test. For example, if the cash value is $2,000, some $500 counts towards your eligibility limit.
- Property: Your home will count towards your Medicaid asset test if you are not planning to return to your home. Most nursing home residents never return to their property, so it must be sold.
For those of you who might wonder why this cruel asset test still applies to the infirm, follow the money:
The government rules require you to pay that full $94,000 – even for many years – until there’s nothing left of your IRAs, bank accounts, etc. Otherwise, if you went immediately on Medicaid, the nursing homes would only receive the government-negotiated price – far less than the list price you pay.
Nursing homes make big money for their hedge funds and bankers, and they can pay for many lobbyists.
Impoverished Medicaid elderly – often four or five in a room without windows – have no lobbyists, no inheritance for their children, hardly pittances for gifts to their grandchildren.
For a report on hedge funds and their impact on nursing homes click here.