More information is coming out about those people who are enrolling in Medicaid. Not all of them are aware that the states all have a right to recover Medicaid health expenses by taking your assets. It’s been a law since 1993 when the gov’t finally figured out that Medicaid was prohibitively expensive. The state can’t take assets while you’re alive (like your house), or if there is a surviving spouse, or if you’re under age 55. But they can and do recover money after your death. California got $44.6 million in 2004 from this very thing. For someone planning to leave a small inheritance to their children it comes as a shock. Now, I’m not necessarily thinking this is a bad thing in all cases, Medicaid is taxpayer funded, and if someone has assets it makes sense that money should go back into taxpayer coffers through estate recovery otherwise gaming the system would be far too easy. I’m still not entirely sure how I feel about it. But for those people who are essentially being FORCED onto Medicaid by the ACA exchanges this presents a real problem, especially if they built a sizable nest egg and want to pay their own way, outside of government control.
It’s not uncommon for someone to be asset rich and cash poor. Farmers come to mind. And the elderly who have done a great job of saving money for retirement, but now have a small retirement income. The vast majority of those people don’t really belong in Medicaid, they have assets they can draw on, and from what I’ve read and heard, a great many would rather pay their own way with insurance. It is often a matter of pride. The ACA is telling people who qualify that they have to get medicaid, and they don’t qualify for subsidies on a regular plan simply because of that Medicaid qualification. I don’t understand this. Why not just give them the equivalent medicaid monthly value toward a standard insurance plan? The answer is because Medicaid has a different payment agreement with doctors, basically doctors are paid a lot less. This in turn means that Medicaid patients have more trouble finding a doctor who will see them. The ACA is forcing people, based on just a couple of factors, into the cattle chute of medicine and without care to how it will affect their level of treatment or their dignity. This is wrong. Very wrong.
Health care sharing ministries are one possible answer. HCSM’s offer a way off the government system, often for less money and with better “coverage”. Samaritan Ministries is an HCSM which doesn’t encourage or require you to join Medicaid or any other government program (like medicare). You can protect your assets, get money from other members to pay your medical bills, and not have to worry about the State coming after your estate when you die.