LTC Bullet:
What Happened to the Center's Save Medicaid LTC Campaign? Tuesday,
July 28, 2009 Seattle-- LTC Comment:
America's long-term care system verges on collapse.
With this mid-course correction, we'll show how private LTCI can
tip the balance back toward universal access and quality.
Details after the ***news.*** *** LTC-TV.
Why all the doom and gloom about LTCI sales?
What can we do about it? The
Center for Long-Term Care Reform's new LTC-TV series tackles those
questions. Check out episode
number one here http://www.youtube.com/LTCTV.
*** ***
"UP" WITH AGING. Read McKnight's LTC
News editor Liza Berger's brief review of the new movie "Up"
here.
She begins: "Finally,
there is a movie that provides a positive depiction of seniors and old
age." View a
"trailer" for the Disney-animated film here.
*** *** CALLING ALL
CLTCs. Tomorrow (7/29/9) at
2PM Eastern, Steve Moses presents a one-hour webinar titled "Can LTCi
Really Work" exclusively for certified-current CLTC graduates.
Over 400 have already registered.
In case you don't qualify, you can read Steve's remarks with the
same title delivered at the 9th Annual Long-Term Care Insurance
Conference in Reno, Nevada on March 30, 2009 here.
Tomorrow's program is sponsored and administered by CLTC (www.ltc-cltc.com)
so please address any inquiries directly to them. We want to thank CLTC for this opportunity to communicate
with so many of the best in the LTCI business. *** *** NEED CE?
We have over 200 "Free CE" cards left over from the 2008
National Long-Term Care Consciousness Tour.
The Tour's "coordinating sponsor," GoldenCareUSA (www.goldencareusa.com)
has graciously donated these cards to help support the Center for
Long-Term Care Reform. They
are the size and shape of a credit card, bearing the Center's logo, and
the words "One Free Continuing Education Course."
All you do is go online, enter the promo code, follow the
"on-screen" directions, and choose the online CE course you
want, up to 20 hours of credit. Here's
how to get yours: become a
new individual member of the Center for $150 per year; renew your
individual Center membership early for $150 per year; or become a
corporate member of the Center (minimum $1,000 per year, see our
"Membership Levels and Benefits" schedule here).
The number of "free CE cards" new corporate members can
receive is negotiable. Please
initiate contact about this offer with Damon at 206-283-7036 or damon@centerltc.com.
*** LTC BULLET:
WHAT HAPPENED TO THE CENTER'S SAVE MEDICAID LTC CAMPAIGN? LTC Comment:
Early this year, I wrote "We have an extraordinary opportunity
right now to expand the market for private LTC financing alternatives, to
save Medicaid LTC for the needy, and to improve long-term care for all
Americans." (LTC
Bullet: Strike While the Iron
is Hot, 1/21/9) That
conclusion was based on the fact that the worst recession since the Great
Depression had devastated state budgets and would quickly force major
cutbacks in the Medicaid long-term care safety net. What an
opportunity for us! "Policy
makers need new ideas," I explained.
"The budgetary predicament has opened their minds.
They're ready to consider proposals that would be too politically
sensitive in better economic times. We
have the analysis and recommendations they need.
The challenge is communication.
Their problems need to find our solutions and vice versa." So I called on
you to join us in an all-out effort to get "our proposals, articles,
op-eds and ideas, preferably with your personal touch in a cover note, to
key people and organizations in your local area."
In
the same LTC Bullet, I called for a "Spearhead Committee" of
"Regional Representatives" of the Center to burnish their
professional reputation locally by working with us to "Save Medicaid
LTC" all across the nation. Then the
federal government intervened. In
the American
Recovery and Reinvestment Act of 2009 (ARRA '09), AKA "The
Stimulus," the feds spent $87 billion of the Act's total $787 billion
to help state Medicaid programs weather the fiscal storm.
They provided a 6.2 percent supplement to states' federal Medicaid
matching funds. So far, so
good. State Medicaid programs
and LTC providers desperately needed this help. But then the
feds did something totally CRAZY that derailed any hope to fix Medicaid
LTC before December 31, 2010, when the supplemental matching funds end.
They made the extra funding from the ARRA '09 conditional upon
states doing nothing to control their hemorrhaging Medicaid long-term care
eligibility systems. To get
the federal windfall, states were forbidden to tighten Medicaid
eligibility rules that were in effect as of July 1, 2008.
If they'd already tightened eligibility in response to the
financial crisis, states had to reverse course and reinstate the earlier
easier eligibility rules. As we've
explained here many times before, Medicaid LTC eligibility is very nearly
wide open. Anyone with income
below the cost of a nursing home qualifies; recipients can retain
unlimited assets in exempt form; and people who still have too much income
or assets can self-impoverish with the help of Medicaid planners.
The only hope for Medicaid LTC to survive as a safety net for the
poor is to constrict eligibility so that Medicaid serves the most needy as
originally intended and no longer functions as the primary LTC payer for
most Americans of all economic levels. But, the ARRA
'09 "stimulus" does exactly the opposite.
It says in essence: "Don't
fix your Medicaid LTC eligibility problems if you want to receive the
billions of dollars the feds have earmarked for you." President Obama
signed the ARRA '09 into law on February 17, 2009.
From that point on, we saw it was hopeless to help states control
Medicaid LTC eligibility, save money, and encourage private LTC financing
alternatives like LTC insurance and home equity conversion.
To pursue that sensible public policy goal, states would have to
forgo billions of federal dollars that effectively subsidize the problem
that caused the financial bleeding in the first place. For the time
being, therefore, we abandoned efforts to help states fix the problem
directly. We expanded last
year's "National Long-Term Care Consciousness Tour" into this
year's "Western Mini-Tour." We took the Silver Bullet of Long-Term Care back out on the
road to educate and motivate more senior advisors. Then a huge and
unexpected opportunity developed. The
State of Rhode Island has a "global Medicaid waiver."
That waiver enables the state's Medicaid program to experiment in
ways otherwise prohibited by federal rules and regulations.
The trade off was that Rhode Island had to agree to a cap on its
Medicaid matching funds. So,
unlike every other state in the country, RI has a strong incentive to
pursue policies that ensure Medicaid helps people most in need and DOES
NOT discourage responsible long-term care planning through private
financing alternatives. We are working with the Ocean State Policy Research Institute
(OSPRI, www.oceanstatepolicy.org)
in Providence, RI to make the most of this unique opportunity.
We'll refine the analysis and recommendations there that all other
states will be able AND WILL HAVE TO apply soon. Why will all
states be able and have to control Medicaid LTC eligibility and encourage
private financing alternatives soon?
Because the federal ARRA matching fund windfall comes to an end
December 31, 2010. Already,
states are running scared: "[L]awmakers
are increasingly apprehensive about what will happen when the stimulus
money dries up. They predict even deeper cuts in services, higher taxes
and raids on rainy day funds to balance budgets. . . .
Economists and other tax and budget experts are predicting several
more years of flat or declining revenues for states. . . . [S]tates will 'face a cliff' if tax revenues do not
start growing significantly by the time the stimulus money stops flowing
next year." (Stephen C.
Fehr, "Tracking
the recession: Lawmakers dreading end of stimulus dollars," Stateline.org,
Monday, July 27, 2009.) It
is becoming increasingly obvious that states will face a revenue cliff
sooner rather than later and that they'll tumble over that financial
precipice by New Year's Day 2011, less than a year and a half from now.
Our job is to get ready, to mobilize so that we can help states
mitigate the damage to long-term care by (1) spending scarce Medicaid
dollars in ways that help the neediest first, (2) mobilizing savings to
incentivize responsible long-term care planning, and (3) educating the
public about the real risk of "going bare" for long-term care.
That's what we are preparing to do at the Center for Long-Term Care
Reform. We're
changing the Center's "2009 Save Medicaid LTC Campaign" into a
broader, longer-term mission to "Save Long-Term Care."
We'll tell you what we're going to do and how you can participate
in forthcoming LTC Bullets over the next few weeks.
Read the Bullets' ***news*** sections, including today's, for
updates. Get ready to join
the Center for Long-Term Care Reform's "Save LTC Campaign." |