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“7 million” number yet more propaganda: Study suggests barely 858,000 previously uninsured Americans have enrolled and paid premiums

By Nick Sorrentino | Against Crony Capitalism | April 2, 2014

PlaneThat’s fewer than 1 in 300 Americans.

But the president is touting 7 million signups. What gives?

It’s called spin, propaganda, BS.

Basically what happened is people got kicked off of their policies and then had to buy new policies which now must be sold through Obamacare exchanges. Very few new people were covered.

Another fail in a long list of Obamacare failures. Funny the White House released the numbers on April Fools Day.

(From The Daily Mail )

The unpublished RAND study – only the Los Angeles Times has seen it – found that just 23 per cent of new enrollees had no insurance before signing up.

And of those newly insured Americans, just 53 per cent have paid their first month’s premiums.

If those numbers hold, the actual net gain of paid policies among Americans who lacked medical insurance in the pre-Obamacare days would be just 858,298. … Full article.

April 4, 2014 Posted by | Deception, Economics, Progressive Hypocrite | , , | 1 Comment

Why I Am a Conscientious Objector to the ACA

By Margaret Flowers | Dissident Voice | March 28, 2014

I have been an outspoken advocate for a Medicare for all health system. During the health reform process, I did all that I could to push for single payer, including being arrested three times for civil disobedience. I was one of fifty doctors who filed a brief in the Supreme Court which expressed opposition to forcing people to buy private health insurance, a defective product. It pains me to see that the Affordable Care Act (ACA) siphons billions of public dollars to create more bureaucracy and transfers hundreds of billions of public dollars directly to the private insurance industry when I know that those dollars should be paying for the health care that so many in our country desperately need.

I am currently uninsured, so I have to make a choice. I don’t qualify for Medicaid and I’m too young for Medicare. By law, I am required to buy private insurance or pay a penalty. But I find myself in the position of not being able to do either. I can’t in good conscience give money to the health insurance industry that I am fighting to eliminate. And I can’t in good conscience pay a tax penalty that will be given to that industry. So, I am going to be a Conscientious Objector to the ACA.

I suspect that there are others who feel as I do. If you are planning to object to purchasing insurance and you support Medicare for all, you might like to join me in sending a letter to President Obama. Click on this link to do so.

The Issue is Access to Care, Not the Number Who Buy Insurance

As the March 31 deadline to purchase health insurance or face a penalty approaches, the public debate is focused solely on enrollment numbers. Great efforts are being expended to compel people to buy insurance. The “Young Invincibles,” a term created to misrepresent uninsured young adults, are being marketed heavily. And Enroll America, a coalition of advocates and health industry executives, is working overtime to encourage volunteers to be creative in the ways they locate and convince people to purchase insurance.

The mass media and politicians are constantly talking about the health care marketplace. We are being indoctrinated with market rhetoric. Patients are called consumers and health insurance plans are called products. The problem with this is that health care doesn’t belong in the marketplace whose logic dictates that care should be denied if a profit cannot be made. Health care is a public good and something that everyone needs throughout their lifetime.

Focusing solely on the number of people who are insured is what the private health insurance industry wants the public to believe is most important. The industry spent tremendous amounts of money and time to get a law that would force people to buy insurance in order to protect and enhance their assets. They want everyone to buy their products and to make people feel reckless or irresponsible if they don’t. This is a massive campaign to distract people from asking the questions that really matter, such as whether people with insurance will be able to afford health care, whether bankruptcies from medical debt will continue and whether overall health outcomes will improve.

In the United States, having health insurance does not guarantee access to necessary health care. In fact, rather than creating health security, the ACA is degrading health care coverage in the US. It is also creating the largest transfer of public dollars to a private industry ever, as UNITE HERE reports “most of the ACA’s $965 billion in subsidies will go directly to commercial insurance companies.”

The Insurance Scam

As Kevin Zeese and I wrote last fall, the ACA is one of the biggest insurance scams in history. It has made the already complex American health system, which spends over a third of health care dollars on insurance-created bureaucracy rather than care, much more complicated. It is based on principles that are the opposite of what are proven to be effective. Instead of being universal, everybody automatically enrolled as we did for seniors when Medicare started in 1965 and as most other industrialized nations do, we created a conservative, means-tested system that depends on individual income.

And instead of creating a single standard of care, so that everyone has access to the health care they need, the ACA locked into law a tiered system of coverage based on different metals: platinum, gold, silver and bronze. Though they may sound good, it turns out that the upper tier plans are not any better than the lower tier plans in terms of what services are covered or where patients can go for care. The major difference is whether a person chooses to pay more up front in higher premiums and pay less when they need health care (upper tier plans) or chooses to gamble on staying healthy and pay less up front, risking higher out-of-pocket costs if they need care (lower tier plans). This is essentially a pay-now-or-pay-later scheme.

And it is a scheme, because there are no guarantees that people who have insurance will be protected from financial ruin if they have a serious health problem. It is essential to remember that nothing about the basic business model of insurance companies has changed. They exist to make a profit and they are very good at it. While they complain about the ACA, because its regulations require more work on their end to find ways around them, it has been very lucrative for them. Health insurance stock values have doubled since the law passed in 2010.

One of their major work-arounds is the use of narrow and ultra-narrow provider networks to discourage patients with pre-existing conditions from buying their plans and leave patients footing more of the bill. Narrow networks exclude at least 30% of local hospitals and ultra-narrow networks exclude at least 70%. This means that if the local cancer center isn’t included in a plan, then people with cancer are unlikely to buy that plan. To make it worse, it’s difficult for patients to determine what providers are included in different plans because the information on the insurance exchange websites has been found to be wrong half the time.

The reason for the narrow networks is that when patients don’t go to an approved health provider, they bear most or all of the costs. The limit on how much money people can be required to spend in addition to premiums doesn’t apply when patients go out of network (and the limit was removed for 2014 anyway). In practice, if someone develops a serious health condition and the hospital or health professional that treats the condition is not in their network, they will have to go without care or find a way to pay for it. And if a person has a serious accident and is taken to a hospital that is out of network, the patient will again bear the total cost. Buying insurance is a health care crap shoot.

The Race to the Bottom in Health Care Benefits

Medical bankruptcy and self-rationing, foregoing necessary care due to cost, are two products of our market-based health system and we can expect them to continue under the ACA, even as more people become insured. Supporters of the ACA often quote the slowed rise of health care spending that has been happening since the financial crash in 2008. They claim it is a sign of the law’s positive effect; however, the slowing is actually due to fewer people using health services. In 2012, 80 million people went without necessary care because of cost.

Self-rationing will continue because there has not been an economic recovery for most of us. More than 80% of people are buying lower tier health plans that require high up-front payments for care at a time when most families are living paycheck to paycheck. The number of people who are considered poor or low income is rising. And, as Paul Bucheit writes, if we updated our standards for measuring poverty to reflect the current economic realities (the costs of food, housing, health care, education, etc), the poverty threshold would be over three times higher than it is now. He adds that half of the US population owns zero wealth because of debt. It is a sad irony that people are being forced to pay monthly premiums for health insurance that will leave them without money for actual care.

And now that lower coverage plans are legal, they are accelerating the race to the bottom in employer health benefits. Employers are shifting more of the cost of health care onto employees, reducing coverage for dependents, moving employees into private insurance exchanges (which do not qualify for subsidies) and penalizing employees for poor health habits, which places the blame for health problems on the individual without acknowledging that many drivers of poor health are out of the individual’s control. While tying health care to employment is not ideal, in the US at least the employer-based plans used to provide better benefits than those on the individual market.

The Practical Solution

The solution to the ongoing health care crisis is obvious. We need to reverse direction completely and move to a national publicly-funded health insurance for everyone. Some call this a single payer or ‘Medicare for all’ plan. We are already spending enough on health care in the US to provide high quality care to everyone. It is just wrong from a standpoint of what works to continue shifting more of our health care dollars to bureaucracy instead of to care and to the private insurance industry which is designed to keep as much for itself as it can get away with. It is immoral to protect insurance company profits instead of protecting the health and wellbeing of our people.

Putting our money into the insurance industry is a step in the wrong direction. The Expanded and Improved Medicare for All Act, HR 676, in Congress, would eliminate the insurance industry and create lifelong comprehensive coverage for everyone. No matter what you choose to do about insurance, tell your Congress member to support HR 676. And if you are one of the millions who do not plan to buy insurance, join me in telling Obama why. Click here to write President Obama.

Margaret Flowers is co-director of It’s Our Economy, co-host of Clearing the FOG Radio and an organizer of the occupation of Freedom Plaza in Washington, DC. She is also with the Health Care is a Human Right campaign in Maryland.

March 29, 2014 Posted by | Deception, Economics, Progressive Hypocrite | , , , , , , | 1 Comment

Obamacare: the Final Payment

By Paul Craig Roberts | CounterPunch | February 12, 2014

The anonymous Obamacare expert, who provided us a year ago with the most complete account of Obamacare available, has returned with an explanation of estate recovery. Obamacare herds the poor into Medicaid which requires some enrollees to forfeit homes and other assets they might have to the state to cover the cost of their medical care. The research article below is meticulous and demonstrates that Obamacare was not enacted to serve the people.– Paul Craig Roberts

Raiding the Assets of Low-Income and Poor Americans

Since writing “Obamacare: Devils in the Details” posted on this site on February 3, 2013, I have investigated in detail other aspects of the insurance industry’s program to bring health care to Americans. In this article I explain estate recovery to which poorer Americans herded by Obamacare into Medicaid are subject. In violation of moral philosopher John Rawls’ second principle of justice, some of the poorest Americans will pay the highest cost of health care as they, and they alone, are subject to having the family home and any other assets they might possess confiscated by the state in order to reimburse Obamacare for the cost of their medical expenses. The compassionate rhetoric aside, Obamacare makes the poor pay the most.

Under what was deceptively named the Affordable Care Act (ACA), commonly known as Obamacare, which is unaffordable for the patient in more ways than one, beginning January 1, 2014, citizens without health insurance must pay a tax penalty to the Internal Revenue Service (IRS). Qualified individuals and families with incomes between 138 and 400 percent of the Federal Poverty Level (FPL) can shop for commercial insurance policies at a Health Insurance Marketplace (an exchange) and may be eligible for a subsidy from the government to help pay for a plan. Those with incomes at or below 138 percent of the Federal Poverty Level will be tossed into Medicaid unless there are specific reasons why they would not be eligible.

The Federal Poverty Level incomes for different family sizes for 2014 established by the Department of Health and Human Services can be found here: http://aspe.hhs.gov/poverty/14poverty.cfm [2] To determine whether you will be put into Medicaid, find the Federal Poverty Level annual income that applies to your family size for 2014 from the HHS tables and multiply the amount by 1.38. If your annual income is not larger than this amount, into Medicaid you go. For example, to avoid being put into Medicaid by Obamacare, a single individual in the 48 states and D.C. needs an income that is more than 138 percent of $11,670 (more than $16,105). A family of four needs an income that is more than 138 percent of $23,850 (more than $32,913). Poverty level incomes in Alaska and Hawaii are higher due to the higher cost of living in those states.

You won’t find estate recovery in the ACA. It’s in the Omnibus Reconciliation Act of 1993 (OBRA 1993)–a federal statute which applies to Medicaid, and, if you are enrolled in Medicaid, it will apply to you.

Estate Recovery

OBRA 1993 requires all states that receive Medicaid funding to seek recovery from the estates of deceased Medicaid patients for medical services received in a nursing home or other long-term care institution, home- and community-based services and related hospital and prescription drug services regardless of age. It also allows, at state option, recovery for all services used in the Medicaid state plan at age 55 or older. At minimum, states must pursue recovery from the probate estate which includes property that passes to heirs under state probate law, but states can expand the definition of estate to allow recovery from property that bypasses probate. This means states can use procedures for direct recovery from bank accounts and other funds. The state keeps a running tally, and even if you have a will, your heirs are chopped liver. Estate recovery can be exempted or deferred in certain situations after your death, but the regulations for this are limited and complicated with multitudes of conditions.

Your estate is what you own when you die–your home, other real estate in which you have a legal interest, personal property, bank accounts, annuities and so on. For cash-strapped states, recovery provides an income stream, and with the expansion of Medicaid states will be in dire need of money, particularly in the current economy.

You must first understand that if an exchange determines you are eligible for Medicaid, you have no other choice. Code for exchanges specifies that an applicant is not eligible for a subsidized plan to the extent that he or she is eligible for coverage under Medicaid. Therefore, when you apply, if you are found eligible, you will be tossed into Medicaid. You can also be auto-enrolled in Medicaid if you are presumed eligible through a database such as SNAP (food stamps). If you are enrolled in a subsidized private plan through an exchange and your circumstances change making you eligible for Medicaid, in you go.

Obamacare revises Medicaid regulations in order to make more Americans eligible for Medicaid. Revised regulations include an increase in age and income limitations, and the asset test no longer applies. Prior to these revisions, applicants were not eligible for Medicaid if they had more than a specific dollar amount in assets. But, under Obamacare, those who likely own a home or have savings set aside–for example, early retirees or people who have lost their jobs and, as a result, are in a low income bracket–will find themselves in Medicaid, and their assets will be looted by the government when they die for medical services used at age 55 and up.

Estate recovery can have a damaging impact on low-income and poor Americans. It is a pernicious death tax on those who have the least and are the most vulnerable. Often, the only asset they have is the family home and what’s in it, and, for some, this has been the family home for several generations. The threat of losing the home causes people to forego health care.

Home equity is part of a deceased Medicaid recipient’s estate and except under certain circumstances is subject to estate recovery. Surviving family members may either sell the home and use the proceeds to satisfy the Medicaid claim or, if they wish to keep the home in the family, they can satisfy the claim with their own personal funds. This Medicaid clawback not only confiscates family property but also robs people of their dignity as Medicaid allows only an amount it considers reasonable for services provided by a funeral home and burial costs. In some states, funeral homes are responsible for notifying Medicaid if there is excess money in a burial trust fund so it can also be pillaged.

Some might think it fair that those who are enrolled in Medicaid pay back the benefits they received. However, under a mandate that requires all Americans to be covered by health insurance or pay a tax penalty to the IRS, estate recovery is unconscionable since Obamacare offers no other viable option for this income-segment of the population. It also discriminates by age since only Medicaid enrollees who use benefits in the state plan at age 55 and up are subject to estate recovery, but those who use benefits at age 54 or less are home free unless they receive long-term care. Under federal law, discrimination is not permitted on the basis of age, but, obviously, the U.S. government turns a blind eye to to its own law. Perhaps, when states need more money due to the Obamacare expansion of Medicaid, and as the jobless economy continues causing more people to be eligible, age discrimination will be broadened to 45 and up.

You may be eligible for an exemption from having to pay a penalty for being uninsured if you meet specific requirements–for example, if you are in jail, if you have a sincerely-held religious belief that prevents you from seeking and obtaining medical care, if you are eligible for Medicaid under its expansion but live in a state that opted not to expand Medicaid, if you are a member of an Indian tribe, and several other situations. But there is no exemption for people who refuse to sign up for Obamacare because of the Medicaid estate recovery program.

Since the plans at the Obamacare exchanges are income-based, you may be put into Medicaid when you apply for insurance. Or, you may start off enrolled in a subsidized plan, confident that estate recovery won’t apply to you, but several months or a year later, due to a change in your circumstances, find you have been tossed into Medicaid. You can increase your income in order to avoid Medicaid, but it would have to remain over 138 percent of the Federal Poverty Level throughout the taxable year. If paying for insurance will deprive you of food or shelter, you can try filing for a hardship exemption, that is, if the government site is working smoothly, and if you can find the form. It is important to understand how this income-based scheme works so you can figure out how best to survive the many caveats of Obamacare. To learn more and what to watch out for, read my lesson on how Obamacare works.

http://www.paulcraigroberts.org/2013/02/03/obamacare-a-primer/ [3]

Estate recovery was not an unintended consequence of Obamacare. The House Ways & Means Committee and The House Energy & Commerce Committee share jurisdiction over health care, including Medicare and Medicaid, and both worked extensively on Obamacare. So, don’t bother thinking that the members of these committees didn’t know that estate recovery would impact millions of Americans who would be tossed into Medicaid. The asset test was dropped and the age limit was increased explicitly in order to expand Medicaid. Yet, did We the People hear any concern about estate recovery? Certainly not in the many floor speeches given by Democrats as well as Republicans or from the media.

Obama stated during his 2008 presidential campaign that transparency would be the leverage needed to ensure that people stay involved in the national health care reform process. The expansion of Medicaid was part of the process. Did Obama or your representatives tell you that Medicaid, depending on your age, is a loan subject to deferred payment by your estate? Did they tell you the government subsidy for a private plan at an exchange is a loan, that must be repaid if your income increases? Transparency was highly selective. The bait was shown but not the hook.

Obama also often made the point that the public should receive the same level of coverage and care as members of Congress. Medicaid is hardly the same level of coverage and care, but, aside from that, tell us, Mr. Obama, because your health care is funded by taxpayers, will your estate be subject to recovery?

The fact that Obamacare did not revise existing federal statute–in other words, it retained estate recovery–most certainly undermines the compassionate rhetoric about helping low-income and poor Americans.

Official Response To Estate Recovery Inquiry

In October 2009 during the national health care reform debacle, eight public-spirited citizens, dismayed as they watched Obamacare morph into deception, signed and faxed a letter to 28 members of Congress, Democrats and Republicans alike, including chairs and ranking members of the various health care policy committees working on Obamacare. The letter addressed “Discrimination, Estate Recovery & Exploitation in National Mandated Health Insurance.” Other recipients included President Barack Obama; Kathleen Sebelius, Secretary of Health and Human Services; and Nancy Ann Deparle, Director of White House Office of Health Reform.

The letter pointed out that absence of choice for Medicaid-eligible citizens other than a costly penalty is discrimination based on economic status. It also stated that the Medicaid estate recovery program discriminates by age and against those who own a home and have other assets versus those who do not. The letter asked if OBRA 1993 had been amended so states would not be allowed to recover assets or place liens on property under national mandated health insurance, and, if there was no amendment, why not?

The citizens who sent the letter received no response from Congress or the Obama administration. The government that comprises ObamaNation, Inc. serves only its money masters.

Depending on their state of residency, Americans can sign up for Obamacare coverage with a federal or with a state exchange. The US Centers for Medicare and Medicaid Services (CMS) is the federal office that established the federal exchange at healthcare.gov at which residents of the 36 states that chose not to use a state exchange can sign up for Obamacare. (New Mexico and Idaho have state exchanges but are currently using the federal one.) Fourteen states and the District of Columbia submitted proposals, which were approved by CMS, to run their own exchanges.

In June 2013 a letter was sent to the Centers for Medicare & Medicaid Services by a well-informed citizen pointing out that the Medicaid Manual prepared by CMS to provide guidance for states contains procedural rules intended to ensure that individuals are informed about estate recovery before they complete the application process.

There are variations in the ways in which states implement estate recovery, depending upon their Medicaid program and state laws. However, Federal law requires all states to incorporate the following protections for Medicaid recipients into the design of their estate recovery program:

— The State should notify Medicaid recipients about the estate recovery program during their initial application for Medicaid eligibility and annual re-determination process.

— The State must notify affected survivors about the initiation of estate recovery and give them an opportunity to claim an exemption based on hardship.

— The State must establish procedures and criteria to waive recovery if it would cause undue hardship.

The letter went on to say that the final CMS Health Insurance Marketplace application (healthcare.gov) notifies applicants about Medicaid’s right to pursue and recover any money from other health insurance, legal settlements or other third parties but does not disclose estate recovery. Since estate recovery is one of the terms of the Medicaid contract, it is deceptive to omit disclosure of this practice. CMS was asked to provide the reasons for this omission.

CMS responded evasively to the concerned citizen’s question. CMS claimed that the Health Insurance Marketplace application at healthcare.gov does not disclose Medicaid’s right to claim against the estate, because CMS wanted to provide flexibility to state Medicaid agencies as to how each one notifies applicants about estate recovery. Some states have developed pamphlets to address common estate recovery questions or devote a portion of a general Medicaid pamphlet to the subject. Some states also post their state plans, perhaps with additional explanatory text, on their web sites.

Even if we take this claim at face value, it reflects a cavalier attitude. As health insurance is mandated with low-income earners and the very poor having no alternative to Medicaid, certainly those subject to estate recovery have a right to be notified in advance of being herded into this insurance plan.

It is well worth knowing about estate recovery before you sign up at an Obamacare exchange so you can make an informed choice as to whether or not you want to get trapped in this Byzantine sinkhole or steer clear, particularly if you think your income may relegate you to coverage under Medicaid now or in the future. Unfortunately, it appears that CMS as well as some of the state-based exchanges, such as Covered California, decided you don’t deserve to know about this particular term of the Medicaid contract when you apply and sign on the dotted line. So, as of this writing, there is no mention of estate recovery on the Obamacare application at healthcare.gov that services residents of the 36 states which use the federal exchange nor for Californians, residents of a state with a robust estate recovery program! Some states disclose estate recovery on their state exchange applications for Obamacare, and others do not.

Non-disclosure of estate recovery on an Obamacare application does not mean that the state in which you reside will not bill your estate for the cost of your medical treatment under Medicaid. It merely means that a conscious choice was made not to let you know that one consequence of signing up for Obamacare could be the loss of your home.

There are a few states that recover for long-term care only. It would be in your best interest to find out your state’s recovery policy so you know where you stand. You should also remain alert to changes.

Here is what you need to know:

When you complete the application at healthcare.gov, it is assumed that when you submit it, you are fully informed and agree to all terms. Submission of the application is akin to signing a contract. Your signature not only means you have provided true answers to all the questions under penalty of perjury, but also that you understand and agree to all the rules and conditions. However, by not disclosing estate recovery CMS expunged your right to make an informed decision. Therefore, you may not realize that your estate can become government property because Obamacare forces you into Medicaid if your income is less than the threshold for a subsidized premium.

When you sign a loan note at a bank, you are agreeing to the terms and conditions of the contract between you and the bank, and these are disclosed in the note. The banker doesn’t say to you, “Just sign here and we’ll let you know the terms later. You can pick up a pamphlet at our local office or request that one be mailed to you. Or, you can visit our website and see if you can find the page that tells you what you just signed yourself into. Thank you. We appreciate your business.”

Even if your circumstances change such that you are no longer eligible for Medicaid and you are shifted into a subsidized Obamacare plan, any Medicaid expenditures you incurred remain as claims on your estate.

According to the federal procedural rules, the state should notify Medicaid recipients about the estate recovery program during their initial application for Medicaid eligibility. Initial is the operative word. It does not mean after an individual has been put into Medicaid. Since healthcare.gov is the initial point of contact for applicants who reside in one of the 36 states using the federal exchange, there is no legitimate excuse for nondisclosure of estate recovery. Healthcare.gov is where the buck stops. The application should contain notification of estate recovery. The same is true for state-based exchanges that omitted this disclosure on their Obamacare applications.

Like terms of a contract, laws are supposed to be known. In Western civilization people are not supposed to be accountable to secret laws or to secret clauses in contracts that they sign. Clearly, if Western legal practice holds, estate recovery is impermissible due to the lack of notice. Only the corrupt architects of Obamacare believe that it is fair to confiscate the assets of an individual or a family without notification that the health care they receive can be charged to their estate.

Liens

Some state-based exchanges requested permission from CMS to add information to their application and chose to include disclosure of estate recovery. The Massachusetts Health Connector application not only includes disclosure of estate recovery, but also goes above and beyond, notifying applicants of liens. “To the extent permitted by law, MassHealth (Medicaid) may place a lien against any real estate owned by eligible persons or in which eligible persons have a legal interest. If MassHealth puts a lien against that property and it is sold, money from the sale of that property may be used to repay MassHealth for medical services provided.”

There are pre-death liens and post-death liens, and whether or not placement of a lien is disclosed on an Obamacare application, this practice is permitted in all states. For more on liens, you should consult an attorney–if you can afford one–or seek information online. It’s not pretty.

Renewal Of Coverage and Auto-enrollment

Note that Obamacare applications contain a section titled Renewal of Coverage in Future Years. An applicant can agree to allow an exchange to use income data, including information from tax returns to automatically renew eligibility for 1, 2, 3, 4 or 5 years, or applicants can check “Do not use information from tax returns to renew my coverage.” Exchanges have access to the federal data hub which keeps track of your income and other personal data. If you gave unfettered access to your data by choosing auto-renewal, they have all the information needed to determine whether you are still eligible for your subsidized policy or should be moved into Medicaid.

The letter sent to CMS in June 2013 also asked about estate recovery disclosure in cases where coverage is auto-renewed during the annual redetermination process, when people are shifted from a subsidized plan to Medicaid due to a decrease in income or other change in circumstance, and when people are auto-enrolled on the presumption that they are eligible according to a database such as SNAP (food stamps) or by a hospital or health care center. A similar letter was sent to the Massachusetts Office of Medicaid.

The federal procedural rules on estate recovery say the state should notify Medicaid recipients about the estate recovery program during the annual redetermination process, but according to the Massachusetts Office of Medicaid, you don’t need to be informed about estate recovery during the redetermination process because you presumably read about this on the original application you filled out and submitted.

If you submitted an application that did not disclose estate recovery, it cannot be presumed that you are aware of estate recovery, because notification was not on the application. Thus, the redetermination procedure is one more example of the failure to disclose.

If you are bumped into Medicaid from a subsidized plan due to a change in your circumstances, the Massachusetts Office of Medicaid believes that you don’t need to be informed about estate recovery because you presumably read about this however many years ago when you filled out the original application. You will simply be sent a notice that you are now in Medicaid, and the notice will refer you to the Medicaid Member Booklet for information on the rules. If you obtain and read the booklet, you can learn that you may be subject to estate recovery. But don’t expect to receive a Medicaid Member Booklet with your notice, because “It would be cost prohibitive to include a Member Booklet with every notice. Instead, every notice includes information on how to contact Customer Service with any questions, including to request a copy of the Member Booklet.”

Hope you know what questions to ask and that you do request a copy of the booklet immediately, pray that it arrives before you use any Medicaid services if you are age 55 to 64 and go over it with a fine tooth comb. If you don’t want to be in Medicaid, you can contact your state Medicaid agency to unenroll, but you’ll probably have to pay a penalty for being uninsured unless you can earn more money and get into a subsidized plan.

If you submitted an application that does not disclose estate recovery and you are bumped into Medicaid due to a change in your circumstances, you won’t know about this detrimental practice, but you can learn that your assets may be confiscated if you contact Customer Service and request a Member Booklet.

If you are auto-enrolled into Medicaid because you were presumed eligible through a SNAP (food stamp) database or by a hospital or health care center, you may still need to fill out a full application which may or may not disclose estate recovery.

Now let’s look at how the federal exchange at healthcare.gov will handle these situations.

The federal exchange will not be renewing coverage for Medicaid recipients. Your state Medicaid agency will handle your annual Medicaid eligibility redetermination (renewal). CMS responded to the citizen’s inquiry as follows: “State Medicaid agencies are developing their own renewal forms which may include a notice regarding estate recovery. CMS is in the process of finalizing a model renewal form to assist states, and we appreciate that you highlighted this requirement.”

Why did CMS need to be reminded about notification of estate recovery when the federal procedural rules that CMS is supposed to implement specify that notification is required?

You may receive a renewal form if your state Medicaid agency doesn’t employ the same “streamlined Obamacare procedures” that Massachusetts is using or if you did not choose auto-renewal. Your state Medicaid agency might come up with its own procedure for redetermination regardless of which option you checked on your original application. In any case, the renewal form might not include disclosure of estate recovery although your state Medicaid agency is familiar with the estate recovery notification requirement outlined in the federal procedural rules.

According to CMS, if you are bumped into Medicaid due to a change in your circumstances, your state Medicaid agency may notify you that you are now in Medicaid and “may include Medicaid-specific information as appropriate.”

If the state Medicaid agency sends a notice that you have been bumped into Medicaid, you might also receive Medicaid-specific information–or you might not. The notice will refer you to a pamphlet and provide you with a website address so you can learn that your heirs can be dispossessed in exchange for your being provided with minimal medical care.

If you are auto-enrolled because you were presumed eligible through a SNAP (food stamp) database or by a hospital or health care center, your state Medicaid agency will most likely send you a full application which might or might not disclose estate recovery.

Oregon fast-tracked residents into Medicaid in October 2013 by sending approximately 240,000 letters to those on food stamps. The Oregon Health Authority already had people’s information on file since they were participants in an income-based state program, and, thus, presumed eligible for Medicaid. The letter explained that all they had to do was let the Oregon Health Authority know they wanted to be enrolled in Medicaid by checking the “I-am-interested” box, provide some basic information on the enclosed one-page form and return it to the Authority in the enclosed stamped and addressed envelope. The Oregon Health Authority then worked on enrolling the 75,000 respondents and proceeded to send 177,000 reminder notices.

http://stateofreform.com/issues/medicaid/2013/12/secret-oregons-fast-track-enrollment-leveraging-bureaucracy/ [4]

Did the one-page form contain notification of all rights and responsibilities including estate recovery?

State Policy Changes

Oregon and Washington disclosed estate recovery on their applications and experienced low sign-ups. People are reluctant to accept having their families dispossessed of what little they have. Officials in both states said that state policy would be changed in order to apply estate recovery only to Medicaid patients in long-term care, and Cover Oregon (the state exchange) decided to remove estate recovery disclosure from its application in order to avoid alarming applicants. The Seattle Times reported that Washington’s Health Care Authority has filed an emergency rule to amend Medicaid’s estate recovery policy.

http://www.oregon.gov/oha/healthplan/OHPSuppDocs/Estate%20Recovery%20and%20the%20Oregon%20Health%20Plan.pdf [5]

http://blogs.seattletimes.com/healthcarecheckup/topic/estate-recovery/ [6]

Privacy Violations

There is no pretending that your information is private or that Obamacare is concerned with protecting your privacy. California’s state exchange, Covered California, provided insurance agents with names and contact information for tens of thousands of people who either logged onto Covered California’s website to check out plans or who had partially filled out an application but did not finish, and did not ask to be contacted. Exectutive Director, Peter Lee, excused this breach of privacy on the grounds that the exchange’s legal counsel approved it and the state wanted to offer more assistance to Californians.

http://articles.latimes.com/2013/dec/06/business/la-fi-exchange-names-disclosed-20131207 [7]

The privacy statement in the application of Colorado’s exchange, Connect for Health Colorado, states: “You release Connect for Health Colorado and the Department of Health Care Policy and Financing from all liability for sharing this information with other agencies.” Some of the sharing agencies include the United States Customs and Immigration Services, Department of Homeland Security and financial institutions (banks, savings and loans, credit unions, etc.).

In the event that your data has been compromised, states must notify you, but the federal government is not required to do the same, and is, therefore, more likely to hide its security flaws and privacy breaches. According to the Washington Post, administration officials knew when the federal site was launched that the privacy of user data would be at risk. An internal Department of Health and Human Services (HHS) memo warned that sufficient testing of data security had not been performed.

http://www.washingtonpost.com/politics/kathleen-sebelius-acknowledges-frustrating-problems-with-health-care-website/2013/10/30/8cf36c98-415e-11e3-a751-f032898f2dbc_story.html [8]

http://www.foxnews.com/politics/2013/12/05/feds-not-required-to-report-security-breaches-obamacare-exchange-website/ [9]

http://freebeacon.com/expert-healthcare-gov-security-risks-even-worse-after-fix/ [10]

Subsidized Premiums And Cost-sharing Reductions Are Also Subject To Recovery

CMS and many of the state-based exchanges also left out notification that the tax credit you receive for a subsidized plan and the reduction in cost-sharing and deductibles are advance loans and could leave you with an unexpected debt to the IRS. Most likely, the lack of this disclosure as well as estate recovery was intentional so people would not be deterred from signing up for health insurance. Thus, CMS and other exchanges unilaterally surrendered your right to know important rules that can adversely impact you and your family. Non-disclosure of all rules, rights and responsibilities is not a standard and acceptable business practice and could be deemed fraudulent in a court of law.

Connect for Health Colorado states your acceptance in the fine print on its application: “I understand that if I am eligible for the Advance Premium Tax Credit (APTC) and/or Reduced Co-pays and Deductibles these payments will be made directly to my selected insurance carrier(s). Acceptance of (APTC) and/or Reduced Co-pays and Deductibles may impact my coverage year tax liability. I will be given the option to apply all, some, or none of any APTC amount I may be eligible for to my monthly premium.”

Do you know what this means? It is notification that you may have to pay back part or all of your Obamacare health premium subsidy and reduced co-pays and deductibles if your income rises during the year.

The Advance Premium Tax Credit is the subsidized part of your Obamacare premium. The subsidy and cost-sharing reductions are based on an estimate of your total income for the year in which you apply for insurance at an exchange. If your income at the end of the year is higher than the estimate, you may have a tax liability for part or all of these two items because they were based on a lower income. To avoid this risk, you can choose to negotiate a smaller subsidy and pay more of your premium to reduce your exposure to possible tax liability for overpayment of the subsidy. Alternatively, you can refuse the tax credit, pay full freight and collect your tax credit based on your actual year-end income when you file your federal tax return. You can’t negotiate cost-sharing reductions, but, you can opt not to apply for these unless you don’t mind shouldering a possible payback.

For details see section 4:

http://www.paulcraigroberts.org/2013/02/03/obamacare-a-primer/ [3]

For current payback amounts:

http://www.gpo.gov/fdsys/pkg/PLAW-112publ9/html/PLAW-112publ9.htm [11]

For payback of the entire subsidy:

http://thehill.com/blogs/healthwatch/health-reform-implementation/144847-1099-repeal-gets-trickier-with-house-bill [12]

Medicaid Managed Care Plans

Some states use private insurers to manage health care for their Medicaid population through Medicaid Managed Care Plans, and the Obamacare expansion of Medicaid is a huge money-maker for these private insurers as well as a huge cost booster for U.S. health care. For giants UnitedHealthcare and WellPoint, as well as for smaller publicly-traded companies such as Molina Healthcare, a Fortune 500, multi-state health care organization, an expanded customer base brings revenue growth. Medicaid Managed Care Plans are hoping to enroll the majority of the expanded Medicaid population.

“This is several hundreds of billions of dollars of new market opportunity for these plans over the next couple of years,” says Jason Gurda, managing director of healthcare with investment bank Leerink Swann in New York.”

http://usatoday30.usatoday.com/MONEY/usaedition/2013-03-08-Text-03062013-0212-PM_ST_U.htm [13]

Many states are choosing to move all or portions of their Medicaid populations to managed care plans. Thirty-five are expected to make changes to their managed care programs in 2014, up from 28 in 2013 and 20 in 2012. States jumping on the privatized-Medicaid bandwagon will mean more profit for corporations and less money allocated to patient care.

http://www.hms.com/popularity-medicaid-managed-care-expected-grow/ [14]

A Managed Care Plan is a system of health insurance which includes a network of contracted providers that are paid a fixed amount to provide health benefits to a defined population. Needless to say, this model relies on restriction and denial of care putting Medicaid patients at risk.

A Medicaid Managed Care Plan adds more charges subject to estate recovery for those who are tossed into Medicaid. The Medicaid Manual says that when an individual age 55 and older is enrolled either voluntarily or mandatorily in a managed care plan, the state must seek recovery from the individual’s estate for the premium payments. If the state plan recovers for all Medicaid services, the state must recover from the individual’s estate the total capitation rate for the period the beneficiary was enrolled in the managed care plan. If the state plan recovers for only some services covered under the state plan, the state must recover from the individual’s estate that portion of the capitation payment that is attributable to the recoverable services, based on the most appropriate actuarial analysis determined by the state.

The manual also states that when the individual enrolls or is enrolled in the managed care plan, the state must provide a separate notice to the individual that explains that the premium payments made to the managed care plan are included either in whole or in part in the claim against the estate.

States that use private insurers to manage their Medicaid population will most likely have capitation payments but might not have reinsurance or fee-for-service programs which can also be recovered from an estate. Therefore, it is prudent to find out what your state has and who is affected. Here are the fees that can be recovered from estates:

Capitation Payments–a fixed monthly fee paid by the state to the Medicaid Managed Care Plan for each month you are enrolled in one of these plans, regardless of whether or not you use any medical services. If you do seek care, capitation payments can exceed the actual costs of services provided during the month.

According to the Massachusetts EOHHS Privacy Office: The estimated average capitation payment for October 1, 2013 through December 31, 2013 was $449.59 per month– an average annual total of $5,395.08. In other words, a person from age 55 through, let’s say, 62, accumulates $43,160.64 on his or her tally against assets including the home. There goes a chunk of your estate even if you didn’t use any medical care.

Reinsurance Payments–An amount reimbursed to program contractors for certain contract service costs incurred by a Medicaid patient that are beyond a contractual dollar threshold. These payments are in addition to the monthly capitation payment.

Fee-for-Service Payments–A direct payment of some or all of a Medicaid member’s medical bills not covered by other available insurance.

According to the Massachusetts Office of Medicaid, with certain exceptions, persons who are eligible for the Obamacare Medicaid expansion (age 21 to 64) must enroll in one of the state’s Medicaid Managed Care Plans.

The hard sell is on for states to privatize Medicaid, and many who are forced into Medicaid by Obamacare will also be forced into managed care plans as is the case in Massachusetts. This represents yet another noose around the necks of low-income and poor people since the three payments described above are recoverable from estates.

Once the limited estates of poor and low-income Americans have been taken to reimburse Medicaid, the U.S. will be left with a permanently poorer and more desperate population and will be faced with higher Medicaid costs as there will no longer be any private property to confiscate.

Pursuant to the Deficit Reduction Act of 2005 (DRA) and clarified in the Tax Relief and Health Care Act of 2006, states were given greater authority to impose and increase premium and cost-sharing charges on certain Medicaid enrollees, but despite these charges their estates are still subject to recovery. Under Obamacare, the government has a right to recover reimbursement from estates of those with lower incomes who are enrolled in Medicaid. Yet, individuals with higher incomes who qualify for a subsidized plan are also paying premiums subsidized by the government but are not subject to estate recovery.

http://kff.org/medicaid/issue-brief/deficit-reduction-act-of-2005-implications-for/ [15]

http://www.nytimes.com/2008/11/27/us/27medicaid.html?_r=0 [16]

Is it fair to impose estate recovery on Medicaid enrollees but not on other subsidy recipients? Is it fair if recovery adheres to the basic requirements in federal statute, but, thereafter, is based on state policy which differs from state to state and, thus, is not applied equally across the nation to all Medicaid enrollees at age 55 and up? Is targeting a specific age group fair? Or legal?

Equal protection is in the Constitution, but ever since the Supreme Court surrendered in the 1930s to President Franklin D. Roosevelt’s New Deal legislation, equal protection has been curtailed in the economic arena. The Supreme Court, unwilling to face down a President asserting previously unknown executive power, accepted the violation of the 14th Amendment in economic legislation in order to avoid being packed with FDR yes-men.

Obamacare was not written for the benefit of the poor and uninsured. It was written for the profits of the insurance companies giving them millions of new customers subsidized by U.S. taxpayers. The business of America is business. Private insurance company CEOs receive multi-million dollar pay packages, while under Obamacare low-income earners and the poor have to give up their homes and other assets in order to receive medical care.

February 13, 2014 Posted by | Corruption, Deception, Progressive Hypocrite | , , , , | Leave a comment

Medical Price Gouging

By RALPH NADER | CounterPunch | January 15, 2014

An epidemic of sky-rocketing medical costs has afflicted our country and grown to obscene proportions. Medical bills are bloated with waste, redundancy, profiteering, fraud and outrageous over-billing. Much is wrong with the process of pricing and providing health care.

The latest in this medical cost saga comes from new data released last week by National Nurses United (NNU), the nation’s largest nurse’s organization. In a news release, NNU revealed that fourteen hospitals in the United States are charging more than ten times their costs for treatment. Specifically, for every $100 one of these hospitals spends, the charge on the corresponding bill is nearly $1,200.

NNU’s key findings note that the top 100 most expensive U.S. hospitals have “a charge to cost ratio of 765 percent and higher — more than double the national average of 331 percent.” They found that despite the enactment of “Obamacare” — the Affordable Care Act — overall hospital charges experienced their largest increase in 16 years. For-profit hospitals continue to be the worst offenders with average charges of 503 percent of their costs compared to publically-run hospitals (“…including federal, state, county, city, or district operated hospitals, with public budgets and boards that meet in public…”) which show more restraint in pricing. The average charge ratios for these hospitals are 235 percent of their costs.

According to NNU’s data, the top 10 Most Expensive Hospitals in the U.S. listed according to the huge percentage of their charges relative to their costs are:

1. Meadowlands Hospital Medical Center, Secaucus, NJ – 1192%
2. Paul B. Hall Regional Medical Center, Painsville, KY – 1186%
3. Orange Park Medical Center, Orange Park, FL – 1139%
4. North Okaloosa Medical Center, Crestview, FL – 1137%
5. Gadsden Regional Medical Center, Gadsden, AL – 1128%
6. Bayonne Medical Center, Bayonne, NJ – 1084%
7. Brooksville Regional Hospital, Brooksville, FL – 1083%
8. Heart of Florida Regional Medical Center, Davenport, FL – 1058%
9. Chestnut Hill Hospital, Philadelphia, PA – 1058%
10. Oak Hill Hospital, Spring Hill, FL – 1052%

The needless complications of the vast medical marketplace have provided far too many opportunities for profiteering. Numerous examples of hospital visit bills feature enormous overcharges on simple supplies such as over-the-counter painkillers, gauze, bandages and even the markers used to prep patients for surgery. That’s not to mention the cost of more advanced procedures and the use of advanced medical equipment which are billed at several times their actual cost. These charges have resulted in many hundreds of millions of dollars in overcharges.

When pressed for answers, many hospital representatives are quick to defer to factors out of their control. It’s the cost of providing care they might say, or perhaps infer that other vague aspects of running the business of medical treatment add up and are factored into these massive charges. Cost allocations mix treatment costs with research budgets, cash reserves, and just plain accounting gimmicks. These excuses shouldn’t fly in the United States.

Few in the medical industry will acknowledge the troubling trend. One thing is undeniably certain however — the medical marketplace is not suffering for profits. Health-care in the United States is a nearly 3 trillion dollar a year industry replete with excessive profits for many hospitals, medical supply companies, pharmaceutical companies, labs and health insurance vendors.

Americans spend more on health care than anywhere else in the world. One would hope and wish, at the least, that this enormous expenditure would provide a quality of healthcare above and beyond that found in the rest of the western world. The reality is that the results on average are no better than in France, Germany, Canada and elsewhere, which manage to provide their quality treatment without all the overcharges.

Much like our similarly wasteful, bloated military budget, the U.S. spends more on health care than the next ten countries combined — most of which cover almost all of their citizens. The United States spends $8,233 per person, per year according to a 2012 figure from the Organization for Economic Co-operation and Development (OECD). The average expenditure of the thirty three other developed nations OECD tracked is just $3,268 per person.

It gets worse. Harvard’s Malcolm Sparrow, the leading expert on health care billing fraud and abuse, conservatively estimates that 10 percent of all health care expenditure in the United States is lost to computerized billing fraud. That’s $270 billion dollars a year!

And unlike other commercial markets, where the advance of technology routinely makes costs lower, the reverse trend is in effect when providing medical care — the prices just keep soaring higher and higher. The flawed, messy Obamacare system will do little to help this worsening profit-grab crisis, which is often downright criminal in the way it exploits tragedy-stricken people and saddles them with mountains of debt.

Steven Brill’s TIME magazine cover story from February 2013 titled “Bitter Pill: Why Medical Bills Are Killing Us” gives an in-depth and highly-researched rundown of the severity of the medical cost problem and provides some of the worst, most astonishing examples of profiteering off of the plight of the sick or injured.

Here’s a fact that puts the full scope of this troubling trend into perspective — Brill writes: “The health-care industrial complex spends more than three times what the military industrial complex spends in Washington”. Specifically, the medical industry has spent $5.36 billion on lobbying in Washington D.C. since 1998. Compare that expenditure to the $1.53 billion spent lobbying by the also-bloated defense and aerospace sector.

One line summarizes the breadth of Brill’s enormous piece: “If you are confused by the notion that those least able to pay are the ones singled out to pay the highest rates, welcome to the American medical marketplace.”

Americans who can’t pay and therefore delay diagnosis and treatment are casualties. About 45,000 Americans die every year because they cannot afford health insurance according to a peer-reviewed report by Harvard Medical School researchers. No one dies in Canada, Germany, France or Britain because they do not have health insurance. They are all insured from the time they are born.

Obamacare, which has already confused and infuriated many Americans — and even some experts — with its complexity made up of thousands of pages of legislation and regulations is clearly not the answer to the problem. Long before the internet, President Lyndon Johnson enrolled 20 million elderly Americans into Medicare in six months using index cardsCanada’s single-payer system was enacted with only a thirteen page bill — and it covers everyone for less than half of the cost per capita compared to the U.S.’s system. (Check out 21 Ways the Canadian Health Care System is Better Than Obamacare)

Enacting a single payer, full Medicare-for-all system is the only chance the United States has of unwinding itself from the spider web of waste, harm, and bloat that currently comprise its highly flawed health insurance and health care systems. It’s time to cut out the corporate profiteers and purveyors of waste and fraud and introduce a system that works for everybody.

January 15, 2014 Posted by | Corruption, Economics | , , | Leave a comment

ObamaCare in California

By JEFF SHER | CounterPunch | January 9, 2014

The morning of January 6th I received maybe my fourth warning email, all in the last week or so, from Covered California, the state agency that administers the exchange where individuals can now buy health plans under the Affordable Care Act, otherwise known as Obamacare.

First they congratulated me for signing up for a new health insurance plan through Covered California. Then the punch line: “In order for your health care coverage to take effect, you need to pay your premium.”

This is a bit disconcerting, because at the same time that Covered California is filling up my inbox with warnings to PAY MY BILL, the insurance company I am supposed to pay hasn’t sent me a bill yet, and they won’t answer my phone calls due to unusually heavy call volume associated “to” the Affordable Care Act.

Meanwhile, my old insurance company, which cancelled my previous insurance plan effective January 1 precisely because Obamacare was scheduled to take effect on that date, is sending me bills for a much more expensive plan to replace the one they cancelled, only I never applied to them for a replacement plan.

Maybe I’m taking these pay-up warnings the wrong way, but the message seems to be that I’m the fly in the ointment, the monkey wrench in the finely oiled machine, the reprobate who is refusing to hold up his end of the deal and pay the nice insurance company for the excellent service they are providing to me.

I get it. It’s on me. If I get hit by a bus next week and don’t have health insurance, it’s going to be my fault, and the new insurance company I selected through the exchange, Anthem (the conglomerate that swallowed what used to be Blue Cross of California), will have valid reason not to pay my claims.

I understand. I’ve heard about “consumer driven health care,” a core principle of Obamacare. You know, it’s the idea that the reason health care costs are so high is because for too long health care consumers have had too big a share of their costs paid by their employers. Low co-pays and deductibles have led consumers to over-consume. If they have to spend more of their own money, they will make better health care decisions. Like they do when they shop for shoes, or flat screen TV’s. It’s just good solid free market logic.

Consumers are responsible for high-health care costs, not insurance companies, doctors, hospitals and pharmaceutical companies. That’s why Obamacare in a few years will impose harsh penalties for any insurance plans (provided by corporations or unions, for instance) that are too good, so called “cadillac health care plans”. You know, that’s the kind of plan that has low deductibles and co-pays, under which you can actually afford to go see your doctor and consult with him about how you should manage your health. How old school is that, what with all the info available on the internet, Web MD and all that. You can make your own health care decisions now.

So I’m pretty clear by now that if something goes wrong it’s going to be my fault and not the fault of my insurance company. So I’m getting a little nervous, despite the fact that I’ve been a health insurance consultant for over 20 years, and I’m supposed to know how to work this system.

You see, I’d like to pay Anthem for my first month’s (January) coverage. It’s not a lot of money, seeing as how it’s subsidized by the federal government in order to enable more people to afford the prohibitively expensive products on offer from the four-headed insurance/doctor/hospital/pharmaceutical Cerebrus that guards the gates to the Hades that our health insurance system has become. By the way, Cerebrus’s job was not to keep people out of Hades. It was to prevent those who had entered from escaping.

Problem is, I can’t pay my bill because Anthem hasn’t sent me a bill. January 6th was the original deadline for paying January bills for the exchange plans. Well, that deadline has been extended now by Anthem to January 15. Will Anthem send me a bill before then? Do I have health insurance now?

Covered California instructed me that if I hadn’t received a bill yet, I should contact the insurance company I selected. They provided a link to a special page that explained what my options were for contacting and paying each company.

For Anthem I can either pay by telephone – and they gave me a phone number to call – or I can pay by mail. How do you pay by mail? You put a check in an envelope and send it to a P.O. Box in Oxnard, CA. O, and make sure you attach the application number assigned to you by the exchange to your check, along with the primary subscriber’s name. That way Anthem will be sure to know exactly who you are and everything will be just fine. No forms, no plan name, no other identifiers. Just a check in an envelope.

Not being real confident with that approach, I called the Anthem phone number. I worked my way through the phone tree, until the moment I identified myself as an applicant, following which I was immediately informed that Anthem would not be able to take my call at this time because they were experiencing unusually high call volume associated “to” the Affordable Care Act. They told me to call back later.

Perhaps you are thinking I got myself into this fix because I was late in filing my application for Obamacare coverage. On the contrary, I signed up for Obamacare and selected my insurance plan and company way back in October.

That was after my friends at Blue Shield of California (not the same organization as Blue Cross in the State of California) informed me in September that the insurance plan I had at the time was going to be cancelled effective January 1, 2014. Of course they offered me alternatives, I could go to the exchange or I could sign up for a Blue Shield plan outside the exchange comparable to the one I already had – with one slight change. The premium for the new, almost the same, plan, would increase from $436 to a cool $709.87 per month.

Same plan more or less. Same person. Same health status. Same age, 63. The only difference: a new player had entered the market. So Blue Shield decided the appropriate price for my plan had increased by 62.8%. Who am I to ask questions? I couldn’t possibly understand. Just the mysterious ways of the free market as divined by the oracles in the Blue Shield underwriting department.

So I went to the exchange and ordered up my comparable and much less expensive plan and just sat back to enjoy the warm glow of knowing that I would have coverage come January 1, 2014.

Along about December I started to hear rumors that maybe the insurance companies were not going to be able to get the bills out on time to enable people to comply with the January 6 deadline for payment.

So I called Covered California again on December 17, and after waiting on hold for about 96 minutes, I spoke with an agent who assured me that yes, the exchange had sent my information to Anthem and I could be expecting a bill. Not to worry, I would be covered Jan. 1 as far as the exchange was concerned. But of course I would still have to pay my bill.

Yes, the agent said, he had heard about the billing problems. He explained that the insurance companies were dealing with a huge number of applications from the exchange. He wasn’t exactly sure when my application had been sent over to Anthem, because the exchange had held up a lot of the early applications until late November because they weren’t sure the insurance companies were ready to accept them before that.

I insisted that the agent provide documentation that our call had taken place and that he had assured me that I would have coverage and that all my information had been sent to Anthem sometime before Dec. 17. He gave me an incident number which he said would be added to my record with all the details of our call.

I thanked him and told him that with his help, if I got hit by a bus sometime after January 1 but before Anthem billed me and I could pay, I was confident I would be able to win the lawsuit that would ensue when Anthem tried to claim I did not have valid coverage at the time of my accident. Not that they would mind you. Insurance companies in this country are notoriously liberal in their efforts to go that extra mile to take into account all extenuating circumstances when paying claims. They really are not known for trying to evade responsibility on the basis of technicalities. I mean, except for that recisions thing a few years back.

For now, I’m trying to stay off the streets and out of harm’s way. I’ll hold out for a couple more days, hoping a bill arrives from Anthem, and then I’ll follow instructions and put a check in an envelope and hope it gets to the right place. Maybe I should send it registered mail.

Maybe I’m not confident because Anthem has had years to prepare for the coming of Obamacare but couldn’t quite get a handle on this highly complicated billing thing. You know, where one agency collects information and confirms applications and eligibility then sends that information to you, and you enter it into your database and generate a bill and send it out. This insurance stuff is really complicated.

Remember, Anthem and the other insurance companies are from the private sector, which is constantly harping at us about how government can’t do anything right and the private sector always does it better.

I find it hard to believe Anthem (and the other companies) didn’t expect an unusually large number of applications, or unusually high call volume for that matter. Remember, Obamacare mandates that millions of people who didn’t have health insurance before have to buy it now.

Perhaps a more reasonable explanation for this administrative mess is that the insurance companies weren’t really all that invested in delivering a successful launch to Obamacare. Which is surprising, since Obamacare is going to deliver them more customers and greater profits than ever before.

Or maybe the explanation runs a little deeper than that: it’s probably been 20 years since health insurance have really focused any energy on delivering good service to their customers. Why should they? There’s very little competition in the industry. The few companies that remain are going to get their share of customers, no matter how poorly they perform. And after all, they are for-profit companies and their primary responsibility is to deliver profits for their shareholders. It’s not really their business to guarantee that people get high quality health care or a system that functions smoothly.

Please don’t think I just have it in for Anthem. That’s just the carrier I chose for my coverage, so it’s the carrier whose system I have had to try to navigate.

My old friends from Blue Shield aren’t much different. They cancelled my old plan effective January 1. But they kept offering me their new, more expensive substitute plan, and even though I never responded to any of their offers, not long before January 1 they sent me a letter thanking me for my application and telling me how much I owed them for my new, more expensive plan.

In other words, they put the burden on me (the reprobate) to call them (only a 30-something minute wait on hold) to cancel a plan I never asked for in the first place.

I don’t see how that’s much different from Anthem putting the onus on me to pay a bill that they haven’t yet bothered to send me.

JEFF SHER can be reached at:jeffsher@sbcglobal.net

January 9, 2014 Posted by | Economics, Progressive Hypocrite | , , , , , | 1 Comment

The Left after the Failure of Obamacare

By Shamus Cooke | Worker’s Compass | January 4, 2014

It’s satisfying to watch rats flee a sinking ship. This is because onlookers knew the ship was doomed long ago, and swimming rats signify that the drawn-out tragedy is nearing an end. A collective sense of relief is a natural response.

The rats who propped up the broken boat of Obamacare are a collection of liberal and labor groups who frittered away their group’s resources—and integrity— to sell a crappy product to the American people.

Those in the deepest denial went “all in” for Obamacare— such as some unions and groups like Moveon.org— while the more conniving groups and individuals—like Michael Moore— playacted “critical” of Obamacare, while nevertheless declaring it “progressive”, in effect adding crucial political support to a project that deserved none.

But of course Obamacare was always more barrier than progress: we’ve wasted the last several years planning, debating, and reconstructing the national health care system, all the while going in the wrong direction— into the pockets of the insurance mega corporations. A couple progressive patches on the sails won’t keep her afloat. It’s shipbuilding time.

It was painful to watch otherwise intelligent people lend support to something that’s such an obviously bad idea. So it’s with immense relief that liberals like Michael Moore, labor groups, and others are finally distancing themselves from Obamacare’s Titanic failure. Now these individuals and groups can stop living in denial and the rest of us can proceed towards a rational discussion about a real health care solution.

The inevitable failure of Obamacare is not due to a bad website, but deeper issues. The hammering of the nails in the coffin has begun:  millions of young people are suddenly realizing that Obamacare does not offer affordable health care. It’s a lie, and they aren’t buying it, literally.

The system depends on sufficient young people to opt in and purchase plans, in order to offset the costs of the older, higher-needs population. Poor young people with zero disposable income are being asked to pay monthly premiums of $150 and more, and they’re opting out, inevitably sinking Obamacare in the process.

Those young people who actually do buy Obamacare plans—to avoid the “mandate” fine— will be further enraged when they attempt to actually use their “insurance”. Many of the cheapest plans—the obvious choice for most young people— have $5,000 deductibles before the insurance will pay for anything. For poor young people this is no insurance at all, but a form of extortion.

At the same time millions of union members are being punished under Obamacare: those with decent insurance plans will suffer the “Cadillac” tax, which will push up the cost of their healthcare plans, and employers are already demanding concessions from union members in the form of higher health care premiums, co-pays, deductibles, etc.

Lower paid union workers will suffer as well. Those who are part of the Taft Hartley insurance plans will be pressured to leave the plans and buy their own insurance, since they cannot keep their plans and get the subsidy that the lowest income workers get. This has the potential to bust the whole Taft Hartley health care system that millions of union members benefit from, which is one of the reasons that labor leaders suddenly became outraged at Obamacare, after having wasted millions of union member’s dollars propping it up.

Ultimately, the American working class will collectively cheer Obamacare’s demise. They just need labor and other lefties to cheer lead its destruction a little more fiercely.

Surprisingly, most of the rats are still clinging to Obama’s hopeless vessel, frantically bailing water. Sure they’ve put on their life preservers and are anxiously eyeing the lifeboats, but they’re also preaching about how to re-align the deckchairs.

For example, in his “critical” New York Times op-ed piece, Michael Moore called Obamacare “awful”, but also called it a “godsend”, singing his same tired tune. Part of Moore’s solution for Obamacare—which was cheered on in the Daily Kos— is equally ludicrous, and follows his consistently flawed logic that Obamacare is worth saving, since its “progress” that we can build on. Moore writes:

“Those who live in red [Republican dominated] states need the benefit of Medicaid expansion [a provision of Obamacare]…. In blue [Democrat dominated] states, let’s lobby for a public option on the insurance exchange — a health plan run by the state government, rather than a private insurer.”

This is Moore at his absolute worst. He’s neck deep in the flooded hull of the U.S.S Obamacare and giving us advice on how to tread water.

Of course Moore doesn’t criticize the heart of Obamacare, the individual mandate, the most hated component.

Moore also relies on the trump card argument of the pro-Obamacare liberals: there are progressive aspects to the scheme—such as the expansion of Medicaid— and therefore the whole system is worth saving.

Of course it’s untrue that we need Obamacare to expand Medicaid. In fact, the expansion of Medicaid acted more as a Trojan horse to introduce the pro-corporate heart of the system; a horse that Moore and other liberals nauseatingly continue to ride on.

But Moore’s sneakiest argument is his advice to blue states to  “…lobby for a public option on the insurance exchange…”

Again, Moore implies that it’s ok if we are “mandated” to buy health insurance, so long is there is a public option. But that aside, the deeper scheme here is that Moore wants us to further waste our energy “reforming” Obamacare, rather than driving it to the bottom of the sea.

Moore surely knows that very few people are going to march in the streets demanding a public option at this point; he therefore knows that even this tiny reform of the system is unachievable. He’s wasting our time. Real change only happens in politics when there is a surge of energy among large sections of the population, and it’s extremely unlikely that more than a handful of people are going to be active towards “fixing” Obamacare— they want to drown it.

Moore’s attempt to funnel people’s outrage at Obamacare towards a “public option” falls laughably short, and this is likely his intention, since his ongoing piecemeal “criticisms” of the system have only served to salvage a sunken ship.

Instead of wasting energy trying to pry Obamacare out of the grip of the corporations, Moore would be better served to focus exclusive energy towards expanding the movement for Medicare For All, which he claims that he also supports, while maintaining that somehow Obamacare will evolve into Single Payer system.

Most developed nations have achieved universal health care through a single payer system, which in the United States can be easily achieved by expanding Medicare to everybody. Once the realities of Obamacare directly affect the majority of the population and exacerbates the crisis of U.S. healthcare, people will inevitably choose to support the movement of Medicare for All, the only real option for a sane health care system.

January 6, 2014 Posted by | Deception, Economics, Progressive Hypocrite | , , , , | Leave a comment

Obama’s Popularity Among the Young Falls in US

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Prensa Latina | December 5, 2013

Young people in the US are disappointed with President Barack Obama’s administration and disapproved of his management of the main problems in the country, a poll revealed today.

Young people were the main support to the president in his election in 2008 and reelection in 2012. That sector of the population is currently showing a marked decrease in their support.

The poll by the Institute for Politics of the University of Harvard that included people from 18 to 29 years of age revealed that 44 percent of that sector disapproves of Obama’s work, compared to 41 percent in support.

The data shows an 11-point fall compared to a poll by the same entity this past spring, and to another poll in the fall of 2009, when 58 percent of the young supported him and 39 percent voted against.

According to Trey Grayson, director of Harvard’s Institute for Politics, this is the lowest level of support for the president since he assumed office in 2009.

Of those polled, 55 percent said they had voted for Obama, 33 percent said they voted in favor of Mitt Romney and four percent chose another politician.

Being asked today about their vote intention, 46 percent said they would vote for the current White House tenant, while 35 percent would do it for Romney and 13 percent would choose someone else.

Asking opinions about health reform, 61 percent of those polled disapproved of Obama’s administration and 57 percent rejected Obamacare, and also 44 percent consider that health care will worsen, while 34 percent said it will remain the same and just 17 percent think that it will improve.

The poll also revealed that frustration is not only against Obama, because 59 percent of those polled do not support democrats in Congress, while 35 percent approved them, but also two thirds of them do not support republicans and just 19 percent support them.

The poll included 2,089 people and defining their political inclination: 41 percent of the young defined themselves as independents, 33 percent as democrats and 24 percent as republicans, and predicted a large number of non-participants in the primary elections in 2014.

December 5, 2013 Posted by | Corruption, Economics, Progressive Hypocrite | , , , | 3 Comments

Obamacare is Doomed by Its Internal Logic

A Black Agenda Radio commentary by  Glen Ford | November 20, 2013

Obamacare is unraveling, not because the administration is particularly incompetent or unlucky, and certainly not as a result of the Republicans’ unrelenting hostility to the Obama health insurance plan. Indeed, ever since the bill’s passage in early 2010, the GOP’s holy war against Obamacare has served to solidify reflexive Democratic support for what has always been a Republican-inspired bill.

The truth is, the Affordable Health Care Act is coming undone because of its own, tortured internal logic. At root, it is a fraud on the public: a scheme to subsidize and more deeply embed a private insurance system that can only make profits by denying sick and vulnerable people health care, and playing different demographics of Americans against each other. As every other industrialized country in the world has already learned, it is impossible to build a genuine, universal healthcare system on a cut-throat capitalist foundation. Private insurers make money by betting against the health interests of their customers. Obama served his corporate masters by conspiring to make tens of millions more Americans into customers of private insurers. He tried to dress up one of the greatest corporate subsidies in history as if it were a solemn national mission, a rebirth of the social compact between the American people. But of course, Obamacare is no such thing; it is a racket to prop up private insurers with public money, while allowing the profiteers to continue to run the show.

You can’t hide a truth that big. The Obamacare website has suffered from terminal complexity because white collar crime is usually quite complex. The web site attempts to reconcile the profit margins and various products of a universe of private insurance corporations, while at the same time pretending to serve the health needs of the people at an affordable cost. Obamacare claims to be in the business of serving both the public and corporate stockholders. But that’s mission impossible. If Obamacare is based on making profits for private corporations – if that is what keeps the system going – then the public’s health care needs will always be an afterthought. And, that will be obvious in the way that the website is organized as a sales platform that matches federal subsidies with corporate products, rather than matching people with the medical resources they need to survive and thrive.

Website complexity and failures aside, Obamacare can never become part of a national social compact, something of which all Americans can be proud. That’s because, by definition, corporate insurance schemes divide people into “winners” and “losers” – although, of course, the big winner is always the corporation. Young, healthy people know they are the fatted calves of the insurance business, and they are avoiding Obamacare like the plague. If this were really a national health care program, like Medicare for All, then most young people would join in the national health care mission. But this is just Obama working a scam for the insurance companies, and young folks know it. Anybody who manages to get access to the web site knows it.

The fatal flaw in Obamacare can’t be fixed. The best thing that could happen would be a quick and total collapse. Large majorities of Americans still support Medicare for All, but Obamacare stands in the way of a real national health plan – just as the Republican right-wingers that invented Obamacare back in 1989 intended.

Glen Ford can be contacted at Glen.Ford@BlackAgendaReport.com.

November 20, 2013 Posted by | Corruption, Deception, Economics, Progressive Hypocrite | , , , , , | 1 Comment

Report: Fewer than 50K have signed up at HealthCare.gov

By Elise Viebeck | The Hill | November 11, 2013

Fewer than 50,000 people have successfully purchased private healthcare coverage using the struggling ObamaCare enrollment site, according to a report.

The figure represents about one-tenth of an initial enrollment target from the Obama administration that has been referred to by Republican lawmakers.

The report by the Wall Street Journal, citing two people familiar with the matter, comes as federal health officials prepare to release official sign-up figures from healthcare.gov for the first time later this week.

The administration has sought to lower expectations about the number, noting problems with HealthCare.gov and consumers’ tendency to purchase health coverage close to deadlines.

Health insurance companies serving the federal marketplaces have received data for between 40,000 and 50,000 enrollees, sources told the Journal.

The administration had hoped to sign up 500,000 people in the month of October, according to documents cited by House Ways and Means Committee Chairman Dave Camp (Mich.), a Republican.

Monday’s release was part of a flurry of estimates shedding light on aspects of ObamaCare enrollment.

Consulting firm Avalere Health reported that about 50,000 people had signed up for either private plans or Medicaid on 12 state-run marketplaces.

The administration and healthcare experts caution that early lags in enrollment can be rectified by big waves later on.

“Enrollment in new programs begins slowly and often takes several months to build momentum,” said Avalere CEO Dan Mendelson in a statement.

“While initial enrollment has been lagging, with aggressive marketing, there is still time for awareness of the program to grow and participation to begin.”

The Health and Human Services (HHS) Department said it could not confirm the Journal’s numbers.

“We have always anticipated that initial enrollment numbers would be low and increase over time,” said HHS spokeswoman Joanne Peters in a statement, citing Massachusetts’ experience with its healthcare reform law.

“As we have said, the problems with the website will cause the numbers to be lower than initially anticipated.”

November 12, 2013 Posted by | Economics, Progressive Hypocrite | , , | 2 Comments

ObamaCare: Worse Than Doing Nothing?

By RUSSELL MOKHIBER | CounterPunch | October 10, 2013

That’s the conclusion of single payer advocate Dr. Quentin Young, national coordinator for Physicians for a National Health Program (PNHP), in his just released autobiography – Everybody In, Nobody Out: Memoirs of a Rebel Without a Pause.

“Had I been in Congress, I would have unequivocally voted against Obamacare,” Young writes. “It’s a bad bill. Whether it’s worse than what we have now could be argued. We rather think because of its ability to enshrine and solidify the corporate domination of the health system, it’s worse than what we have now. But whether it is somewhat better or a lot worse is immaterial. The health system isn’t working in this country — fiscally, medically, socially, morally.”

Young rejects the idea that President Obama should have compromised on single payer in the face of industry opposition.

“I don’t have any sympathy for the idea that the president had to compromise because his opposition was strong,” Young writes. “Winning is not always winning the election. Winning is making a huge fight and then taking the fight to the people — re-electing people who are supporting your program and defeating those who aren’t.”

Young first met the young Barack Obama in the mid-1990s at social gatherings.

At the time, Obama was lecturing at the University of Chicago Law School and practicing law.

“We did not become bosom buddies after a few of these social gatherings — I just viewed him as a nice, bright guy living in the neighborhood,” Young says.

When Obama ran for the Illinois Senate, Young supported him.

“I was happy with his views on health care,” Young writes. “He recognized that major reform was necessary and indicated support for a single-payer approach. No blushing friend, I took every opportunity to solidify his position. While not an official adviser, I tried to influence him as much as I could. My colleagues and I sent him notes touting the advantages of single-payer and the form it might take and talked with him and his staff about it whenever I had the chance.”

“I felt I did influence him,” Young said.

When Obama ran for the Senate in 2003, Obama told the Illinois AFL-CIO:

“I happen to be a proponent of a single payer universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.”

But just a year later, Obama had flipped and came out against single payer in Illinois.

“I was very disappointed by his move to the right to keep the insurance companies in command,” Young told the Springfield State Journal Register in 2004. “I’m not accusing him of lying or misconduct. I’m accusing him of a lack of courage.”

But despite Obama’s “lack of courage,” Young supported Obama in his run for U.S. Senate and later for president. Young was just setting himself up for more disappointment.

At a town hall meeting in Portsmouth, New Hampshire in August 2009, Obama was asked whether he supported a universal health care plan.

“First of all, I want to make a distinction between a universal plan versus a single-payer plan, because those are two different things,” Obama said.

“A single-payer plan would be a plan like Medicare for all, or the kind of plan that they have in Canada, where basically government is the only person — is the only entity that pays for all health care.  Everybody has a government-paid-for plan, even though in, depending on which country, the doctors are still private or the hospitals might still be private.  In some countries, the doctors work for the government and the hospitals are owned by the government.  But the point is, is that government pays for everything, like Medicare for all.  That is a single-payer plan.”

“I have not said that I was a single-payer supporter because, frankly, we historically have had a employer-based system in this country with private insurers, and for us to transition to a system like that I believe would be too disruptive.  So what would end up happening would be, a lot of people who currently have employer-based health care would suddenly find themselves dropped, and they would have to go into an entirely new system that had not been fully set up yet.  And I would be concerned about the potential destructiveness of that kind of transition.”

“All right?  So I’m not promoting a single-payer plan,” Obama said.

In March 2010, Congress passed the Affordable Care Act — Obamacare — by a narrow margin.

“PNHP’s policy experts did a line-by-line examination of the bill and, while acknowledging that it contains some modest benefits that make changes around the edges of our existing system, basically gave it two thumbs down,” Young writes. “To this day, much to the chagrin of many of our friends who wanted reform, I remain adamant in my rejection of Obamacare.”

“Why? We want a system that excludes the private insurance companies,” Young writes. “ We demand such exclusion not because these companies are good or evil (although we think they’re pretty evil). Rather, the reason to exclude them is that they don’t address the needs of the American people.”

Young also rejects the idea of a “public option,” pushed by Democrats such as Howard Dean. A public option “would not have made any significant difference on the overall impact” of Obamacare “contrary to the view of many progressive who believed that it would,” Young says.

“Since WWII, we have learned a lot about disease and certainly have had dramatic improvements in what we can do,” Young writes. “I’m talking about surgery of the heart, vaccination, nutrition issues. All these things have been largely defined in the last half-century. We’ve had something approaching a 12-year life expectancy rise just from scientific intervention.”

“We have all this knowledge, all these options, but we have a very backward financing and delivery system and the result is a great deal of human suffering,” Young says. “And that’s why we remain opposed to the Affordable Care Act. We think we have a winning proposition despite the reality in Congress. Polls repeatedly vindicate our position. A solid majority of the public and 59 percent of doctors support the single payer approach.”

“President Obama could have made it happen,” Young says. “He could have stuck to all the virtues of single payer. And I won’t deny he may have been defeated in the first round. There’s no question that this fight has been dirty and it’s going to get dirtier.”

October 10, 2013 Posted by | Economics, Progressive Hypocrite, Timeless or most popular | , , , , | Comments Off on ObamaCare: Worse Than Doing Nothing?

ObamaCare Clusterfuck: After 55, Medicaid is a loan you pay back from your estate

Corrente – 06/29/2013

Jeebus, it’s like they’re doing everything possible so that you don’t make it under the wire to 65, isn’t it? Here’s the text of a 2010 letter on NJ letterhead (“MEDICAID COMMUNICATION NO. 10-08”):

The Division of Medical Assistance and Health Services (DMAHS) is reinforcing and updating guidelines that were issued in Medicaid Communication No. 00-16, dated August 10, 2000, governing the recovery of correctly paid Medicaid benefits from the estates of deceased Medicaid clients or former Medicaid clients. The following is a list of important points to remember when determining eligibility and discussing this topic with applicants, clients, authorized representatives and families:

• Medicaid benefits received on or after age 55 are subject to estate recovery. This is specifically stated and acknowledged on the authorization page of the PA-1G Medicaid Application Form.
• DMAHS has an immediate right to recover from the estate unless there is a surviving spouse or child(ren) who is under age 21 or who is blind or permanently and totally disabled. Should any of these exceptions to DMAHS’ right to recover from an estate no longer apply (e.g., death of surviving spouse, attainment of age 21 by surviving child, or death or termination of disability of blind or permanently and totally disabled child), DMAHS has a right to recover from any remaining estate assets at that time.
• Estate recovery in New Jersey includes payments for ALL services, not merely services for institutionalized clients. There is no limitation on the type of service for which DMAHS can recover its payments from estates including managed care (HMO) capitation fees. However, effective January 1, 2010, Medicare cost-sharing benefits paid under the Medicare Savings Programs such as “Buy-in”, Specified Low-Income Medicare Beneficiaries (“SLMB”) or Qualified Individuals (“QI-1”) are not subject to estate recovery.
• The estates of deceased clients who were enrolled in various Title XIX Waiver Programs (such as ACCAP, GLOBAL Options, CCW, etc.) ARE subject to recovery. The only current exceptions are HCEP and JACC, which are State- funded programs through other State Departments.
• The client’s primary residence, while exempt for eligibility purposes, is considered part of the client’s estate, and therefore is subject to recovery. It is also important to reinforce with applicants, clients and families that any interest that the client had in any property at the time of death will be considered part of the decedent’s estate, and therefore subject to recovery.
• Annuities are required to be disclosed upon application and recertification for Medicaid. For those annuities which are determined not to be subject to asset liquidation, the State of New Jersey must be named as the remainder beneficiary in the first/primary position for the total amount of medical assistance paid on their behalf. In the case where there is a community spouse and/or a minor or disabled child, the State must be named in the second/secondary position as remainder beneficiary. The State or its eligibility agencies shall require verification of the State being irrevocably named as the remainder beneficiary in the correct position and the State needs to be notified of any contractual changes in the annuities’ income or principal. The remaining benefits of an annuity not subject to liquidation prior to eligibility determination are payable to the State (primary or secondary position) regardless of the age of provided services
• “Estate” for Medicaid recovery purposes is now defined by law to include any real or personal property and any assets in which the client had any legal title or interest at the time of death. Included for your reference is a copy of the pertinent regulation. Please note that the definition of “estate” appears at N.J.A.C. 10:49-14.1(e)2 and is quite comprehensive; also note that the term “other arrangements” used in that subsection includes testamentary trusts and annuities.
• Please remember that in the process of estate recovery, DMAHS will file a lien against the estate to recover all payments for services received on or after age 55 (except for annuities).
• No distribution can be made to heirs or creditors from the estate other than for reasonable funeral expenses, costs associated with the administration of the estate, debts owed to the Office of the Public Guardian for Elderly Adults, and claims with preference under federal or state law (e.g., IRS liens) that may be superior to Medicaid’s (e.g. filed prior in time) without first satisfying the Medicaid program’s lien.

And what’s so reprehensible about ObamaCare is that they force you into Medicaid. No options if that’s how the eligibility plays out; if you want to risk a piece-of-crap policy so you can pass on your house to your kids, you can’t do that. Yet another path to downward mobility! Of course, this only applies to the poorest, ObamaCare being ObamaCare.

NOTE Yet one more reason why single payer Medicare for All is the only fair solution.

Although this PDF is from NJ, it reads to me like they are passing along a Federal policy. Key words to research are “Medicaid estate recovery” +your favorite of the 50 states.

Aletho News recommends perusing the comment thread at the source for more information.

October 5, 2013 Posted by | Civil Liberties, Deception, Economics, Progressive Hypocrite, Timeless or most popular | , , , , | Comments Off on ObamaCare Clusterfuck: After 55, Medicaid is a loan you pay back from your estate