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GOP Medicaid Plan Could Ruin Relatives, Democrats Caution

By Elizabeth Shogren
Los Angeles Times

Congressional Democrats warned Thursday that financial peril awaits the spouses and children of nursing home residents if Republicans, especially those in the House, push through their version of Medicaid reform.

While much of the debate over Republican health care proposals has focused on Medicare, the government's primary health-care program for the elderly, a second wave of anxiety is arising over a separate GOP blueprint for overhauling Medicaid. The Medicaid program provides health care to the poor, disabled and pays for most of the elderly Americans in nursing homes.

As Congress struggles to complete its plan for balancing the federal budget over seven years, opposition is growing to several elements of Medicaid legislation, especially a provision that could require elderly Americans virtually to bankrupt themselves to obtain subsidized nursing home care for their spouses.

Other provisions of the Republican plan would allow states to put liens on the houses of Medicaid nursing home patients and make adult children financially liable for their parents' nursing home care.

The measures are part of GOP plans to transform the $160 billion Medicaid health-care program by ending the federal guarantee that all eligible Americans get care and giving states lump-sum grants along with the authority to design their own programs and determine eligibility.

Republicans argue that lifting the restrictions is necessary to their drive to shift power from the federal government to the states.

Democrats contend that the federal restrictions are needed to keep states from pushing the relatives of nursing home residents into poverty.

"Most people did not really believe these kinds of Draconian cuts were really going to come," Sen. Patty Murray, D-Wash., said in a news conference Thursday.

Murray said her office is being swamped with calls from worried constituents. "The public is beginning to understand this does not affect just a few people, but every American family."

Seventy percent of the more than 2 million elderly Americans living in nursing homes rely on Medicaid to cover their costs, which average $38,000 a year.

Perhaps the most contentious provision is a House Republican plan to eliminate a law that shelters the last $15,000 of savings and $1,230 of income monthly of spouses whose partner requires nursing home care. Until a couple draws down to that level, they generally are not eligible for Medicaid and must pay for nursing home care.

That provision, known as "spousal protection," was added to Medicaid in 1987. Until then, states set their own income provisions. Under state laws at the time, spouses were allowed to keep an average of just $2,700 in savings and contribute all but $340 of their monthly income.