Estate Planning

Health Care Reform and Long-Term Care

By Kristin L. Burrows

One of the shortfalls of Medicaid for long-term care is that it provides financial assistance primarily for nursing homes, and I don't need to tell you that most people prefer not to have to go into a nursing home. While Medicaid does cover some community-based in-home assistance, there are such long waiting lists that it is not a viable option for the older population. North Carolina offers a program called Special Assistance that provides financial assistance for assisted living facilities, but the program has an income cap that falls well-short of the cost of assisted living facilities, meaning that many people make too much income (even from a single Social Security check sometimes) to qualify for the assistance, yet cannot afford the private pay rate of an assisted living facility.

All this is to say that if someone needs help with some daily activities such as preparing meals, driving to the doctor, dressing or bathing, but does not have a family caregiver or the financial resources to get the level of care they need to stay at home or in an assisted living facility (or run out of money while paying for it), that may mean that Medicaid and a nursing home is the only remaining option.

The sad part about this is that the in-home care services needed to remain in the home often cost less than the nursing home. Some provisions in the federal health care reform seek to remedy this. Regardless of how you view the health care reform overall, these provisions are positive changes – they benefit both the recipients and the taxpayers. If more people who would have had to go into a nursing home and rely on Medicaid are able to stay in their home, and keeping them in their home costs taxpayers less than paying their way in a nursing home, that's a win-win situation.

For an article summarizing the provisions in the Affordable Care Act that will address long-term care: http://www.familiesusa.org/assets/pdfs/health-reform/in-perspective/In-Perspective-Long-Term-Care.pdf

Full post as published by North Carolina Estate Planning Blog on November 17, 2010 (boomark / email).