tag:blogger.com,1999:blog-8512362.post3661235116788562444..comments2024-03-10T13:59:19.230-04:00Comments on xpostfactoid: ACA marketplace enrollment in Covid-19 season: Flat? Up a million? Both?Andrew Sprunghttp://www.blogger.com/profile/17601269968798865106noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-8512362.post-81490074867241267852020-10-10T10:25:19.592-04:002020-10-10T10:25:19.592-04:00I was a friend of one of the families that challen...I was a friend of one of the families that challenged estate recovery in MN.<br />This practice is a grotesque attempt to tax the beneficiaries of social insurance. <br /><br />Now, the majority of the non-seniors who get Medicaid are about two pay periods from homelessness. They are not going to be leaving any taxable estates to anyone.<br /><br />However this idiotic law is a concern to some seniors in nursing homes. However, my impression is that the income and asset tests to even get Medicaid for a nursing home stay are very stringent. So again, estate recovery is repulsive but I think it will be very, very rare.<br /><br />Let me know if I am correct on this.<br />Bob Hertzhttps://www.blogger.com/profile/08889826739646491269noreply@blogger.comtag:blogger.com,1999:blog-8512362.post-64960273313961351412020-10-09T13:45:20.599-04:002020-10-09T13:45:20.599-04:00I appreciate this detail:
"The emergency ext...I appreciate this detail:<br /><br />"The emergency extra $600/week unemployment insurance provided for up to four months (now expired) by the CARES Act does not (did not) count with respect to Medicaid eligibility, but did count in calculation of marketplace subsidies."<br /><br />(i.e. the $600 not counting for Medicaids and expanded Medicaid, yet counting for on-exchange subsidies) which I did not know.<br /><br />As you may recall from prior comments of mine here, since it is underpublicized relative to the rest of the flaws in the current ACA, I have a special concern over Medicaid estate recovery on expanded Medicaid and other non-long-term-care Medicaids, because, in the presence of the recovery, the coverage is not "insurance", but rather can be just loan, until death, for all medical expenses payed out. That's not insurance. It's a loan. (Whether the states recover all medical bills paid out, or just capitations, seems to be at the states will, perhaps tied to how it itself paid for Medicaid coverage. Minnesota, when it was doing the recovery, indicated it gave itself both options.)<br /><br />For those unaware, the recovery is done in 10-14 states (including blue MA, MD, and NJ) currently, on ACA expanded Medicaid, and other standard medical expense Medicaids for people 55 and older. (The status is fairly well documented in the Wikipedia article on Medicaid estate recovery, which I put the info into myself. Wikipedia is not reliable in itself, but the references are all there and online for verification.)<br /><br />(I know the author of the blog is aware of the issue, as he commented on it with shock maybe a year ago in a blog post.)<br /><br />Besides being a problem for lower-income people in passing on modest wealth, and a snag for some others with assets to lose, who don't know about the ill-publicized estate recovery, I note that many states, such as my own MA are going around switching people to expanded Medicaid as they lose their jobs from covid. Mostly it's a good thing, but for many, those over 55 in our state like MA that does the recovery, if people have assets to lose, it's a real bomb that they're gibing people. (The state does not warn people of the bomb. If they actually have enough saved to afford it, they can get real not-a-loan insurance as non-subsidized on-exchange plan. But MA, as with many states, doesn't tell people conspicuously.)<br /><br />Anyway, your own text that I quoted brings up another problem with our crazy patchwork system. Since eligibility for any Medicaid, including ACA expanded Medicaid, makes one ineligible for a subsidized on-exchange plan under ACA rules, in the 14 states, the disregard of the $600 is forcing more people 55 and older onto the just a loan potential bomb of non-insurance!<br /><br />(Of course, the issue becomes rather moot if the full ACA is taken out by the Supreme Court next June, so perhaps we should wonder why any of us are potentially wasting our time worrying about these details with the ACA.)Norman Spierhttp://nasmusicsoft.comnoreply@blogger.comtag:blogger.com,1999:blog-8512362.post-12624073137443732512020-10-09T06:07:28.745-04:002020-10-09T06:07:28.745-04:00Thanks for good observations. I did not realize th...Thanks for good observations. I did not realize the impact of those $600 weekly payments on ACA subsidies. If a person got $600 a week for four full months, that is 16 weeks and $9600 of extra income. As you say, that can blow you right out of a good subsidy on ACA plans.Bob Hertzhttps://www.blogger.com/profile/08889826739646491269noreply@blogger.com