Budget Slashes For Seniors

By: Sanford R. Altman, Esq., retired

Question:
With all the budget cuts the Governor is seeking, is there anything in particular that will affect those of us who are seniors?

Answer:
While it might be somewhat of an oversimplification to say that seniors are a prime target of the Governor’s budget axe, drastically reducing medicaid is the only area that I know of where an actual task force has been appointed for this purpose. It’s called the Medicaid Redesign Team and, since cut backs in Medicaid directly impact home care and nursing home care for seniors, this is not a team that I am rooting for. In a short period of time, the team came up with hundreds of proposals to slash Medicaid, about 50 of which still survive for presentation to the legislature. The following examples serve to illustrate the scope of these propositions:

When a person applies for Medicaid, whether in need of care at home or in a nursing home, each application demands intimate details and documentation. If your spouse has more money than the law allows, you won’t be eligible for Medicaid. It doesn’t matter where the spouses money came from – an inheritance from his or her parents, money from before the marriage – the same result. When I first started practicing elder law many years ago, I was constantly asked by couples, “Should we get divorced?” My answer was always “no, we will work around it”, never seeing divorce as an answer for financial difficulties. The way that the law allowed us to work around this situation was called the spousal refusal. A spouse is allowed to state that they would not make any of their assets available and thereby avoid becoming impoverished or seeking divorce. This seemed fair because it wasn’t the spouse who needed the nursing home or intense home care. The Medicaid Redesign Team purposed to totally eliminate the spousal refusal. If it becomes law, I expect many more requests for divorces. Is this a worthy goal?

A second proposition of the team worthy of note would permit the county to recover everything they have spent on Medicaid for an individual from his or her estate regardless of how it is passed down to one’s heirs. As the law is now, recovery can only come from ones “probate estate”, assets that go through the court. The changes offered in this regard would expand this recovery into assets where your children are to inherit as listed beneficiaries. The most brutal of these would be where you have added your children onto the deed for your home and you have retained only a “life estate” sometimes referred to as “life rights”. One may certainly ask, “should you be denied the right to pass on your home to your children simply because you became ill at the end of your life and needed nursing home care?”

These, along with the many provisions that would make homecare for most seniors a thing of the past, is presented as a quick fix package which, in essence, attempts to balance the budget on the backs of seniors. They even have paid for radio ads encouraging you to tell your state legislator to vote for the whole package, billing it as a savior for both the budget and the health care system. What I encourage is we all read each and every provision-they are short, and on the New York Department of Health Website- and tell your legislators to do the same. If they can’t take the time to fully assess the devastating human toll on our seniors of each provision, they should vote the package down.