Pending Federal Nursing Home Overhaul Bill

Jo C.

https://www.yahoo.com/news/nursing-home-overhaul-bill-boost-170022034.html

Joe C.

Although I applaud efforts to increase care at Long Term Care Facilities, I have not seen anything in the proposed legislation that will help those of us in a self pay situation. Therefore any increased cost will be borne by the spouses/families for me and others in my situation. I have written to my US House Representative suggesting they make some tweaks in the tax code to provide some relief for people who are in this situation.  Needless to say I only received the most generic of responses. It really irks me that my Medicare IRMA cost increase because I am withdrawing money from my IRA to pay for thing that Medicare does not cover. 

JJAz

Joe,

If your wife is in Memory Care because she is unsafe without supervision, then the costs that you pay should be deductible on your 1040 - Schedule A.  While it's not a dollar for dollar offset to your IRA withdrawals to pay for her care, it goes a long way toward reducing the tax effect of your income.

Joe C.

JJAz, Thank you for your comment and I am well versed in to tax code. My angst arises from what is and is not being proposed by our political leaders. If they can propose things like universal child care then why not universal adult care, if you can have propose student loan forgiveness then why not LTC facilities cost forgiveness, if you can propose have free community college then why not government funded respite breaks. I feel we are a forgotten population. Yes, there has been hundreds millions of dollars of spending proposed for LTC for those who a Medicaid eligible but not a red cent for those who are self funding. I am not wealthy but worked hard and saved for a comfortable retirement but most of that will be gone by the time this journey is over. To be clear I am NOT a political conservative and feel there is merit in many of the current proposal but there is nothing in the trillions of dollars of spending to help people who are self funding care of LOs. As you are aware the cost of LTC easily dwarfs the cost of a college education, it would be nice if they at least threw us a bone.

Jo C.

Joe, I absolutely agree with you. It continues to astound and anger me in that the elderly as well as the middle class of citizens have been left without any place to find relief..

No First Lady has ever chosen the elderly or disabled as her special focus.  We get vegetable gardens, we get advised to be best; we get reading for children, we get drug focus, we get children by the bushel; but nowhere do we see the elderly population; evidently they do not make good photo ops.  We also do not make any noise as so many other groups do.  We do not get all the media attention; we are the forgotten despite this country having been built upon the shoulders of this population of citizens..

Everything you say is so true, Joe.  If one wants to really feel shock one can go even further and use Google and read about the deregulation of NHs and reduction in fines and accountability and removing Infection Control staff, etc. by the last administration.  In this, they even reinserted the admission contract admission clause making arbitration mandatory.   How did all of this come about?  I myself only just found out - check out who the largest and most powerful lobbyist was in Washington and what his connections are that caused such overwhelmingly damaging changes . . . . The entire situation is shocking.

Please do not think I am going political on one group of politicos; I am not and would not care what party that individual and his minions belonged to; it is the actions in the best interests of the at risk people who cannot fight back that was annhilated; this really and truly happened and we are still living with the impacts and echoes of that.

For financial survival; one must either be quite wealthy or one can be impoverished and able to obtain Medicaid.  The middle?  Well; too bad.   So many of the middle class spend all of their savings; even selling their homes in order to pay for a LOs care; they themselves are then left with nothing for their own care as they age.   Appalling.  And in this country. 

Norway from the cradle to the grave; not a penny out of pocket - BUT their tax rate is huge.  Yet; the vast majority of citizens are happy and feel safe from being impoverished and the care components from cradle to grave is excellent..

Can't even watch much of the news anymore. Everything; everything is political . . . . not government of the people, by the people for the people . . . .. seems to have become government TO the people and not always in the people's best interests. Only those who can raise huge numbers of loud media focused groups can get anything done - not to address such in your face noise means that, it would ruin politician's re-election possibility.  Squeaky wheel on steroids.

I do not know what the answer is; strange when the aged and aging populations are so huge - but as big as these groups are; nothing strongly grass roots happens to reach out.   We need to get loud at election time and make it an election issue.  But how and who . . . . .

J.

Cherjer

Joe C...you have taken the words out of my mouth. My husband worked so hard and was cautious about saving for the future. Unfortunately, we don't have Long Term Insurance, but he always stated that our savings would see us through...never entered our mind that AD would be our future. He is not in memory care, and I hope I can care for him at home but that might not be possible as the disease progresses. There are not breaks for private pay...why? I guess we know the answer.

Jo...your comments were excellent. There will never be a cure for this disease in my life time but sure would be helpful to get some financial relief and be able to pass on some inheritance to our children/grandchildren. 

t

Jo C.

We applied for Long Term Care Insurance and were both turned down.

At the time we applied with several companies, we were younger; but my DH has Type 2 Diabetes - well controlled on a good diet.  Me?  My doctor's records recorded my having arthritis in my left knee and that I occasionally took Advil as needed.  I was highly active, power walking each morning and doing water aerobics class five days a week and gainfully employed; yet, I was still considered a risk.

Taking out a policy in one's 20's or 30's when health is perfect leads to lower premiums BUT those premiums with premium "adjustments" continue on and on and on for years until needed in one's 70's, 80's, or 90's.  Those premiums are helping to pay for the care of elders already receiving benefit payout as well as for insurance company profit.  It is BIG business.

Those two items in our medical records caused LTC insurance denials for both of us.  As it is, LTC insurance has been caving and many of those who have policies are unable to keep them due to intolerable costs; yet cannot afford the cost of NH care:

https://www.latimes.com/business/story/2019-07-24/long-term-care-insurance-disaster

Cost of NH Care by state for one person (not both spouses - double it for that if such care is needed for both spouses):

https://www.medicaidplanningassistance.org/nursing-home-costs/

There is so much written about the LTC insurance issues.   The risk to profits is very high for insurance companies and selling the product today to make a profit is difficult as the population of the aging who are living longer is spiraling upward along with need for insurance payout which may or may not happen; it can be quite problematic.  The premiums are so much higher; some paying over $3,000 a year and more at a younger age for just one person.  If a person waits until age 70 for a policy, it can cost as much as up to $14,000 a year for policies for both spouses.  Others, still paying far too much are choosing policies with lesser payout with less coverage which still leaves the person having to make stubstantial rest of payment coverage themselves.  Some policies may cover for low NH coverage, (sometimes only $100/day); but will not pay for care in the home, etc.  NH costs can in some areas be upward of $100,000 per year if one must pay privately . . .  middle class citizens often get priced out the market at both ends. 

So much is needed, but this is something that never sees the light of day in a truly meaningful manner by the legislators.  The middle class of citizens certainly do need a hand up; I do not  know if it will ever happen and it is really frightening for most people in its implications as they age and/or become caregivers.

Many of our parents and ourselves have overall tried to save what could be saved and position ourselves for retirement - but never did most of us see the horrendous impact that long term care needs that aging would bring; just did not know.  Lots of open public information and education is needed early on; loudly and often.

 J.

Rennbird

I agree whole heartedly.  The entire attitude towards the reality of Dementia is one of denial.  I always had the feeling that society would just as soon line up our loved ones and shoot them.  After all, if you aren’t producing anything you are worthless.  Children have a future but the aged are a drag.  The final three months of my husband’s life were spent in a Veterans funded facility.  It was like a holding pen.  The patients spent the day in a small windowless room and the entertainment was CNN.  I think the only reason my husband made it for three months before dying was because back in the sixties, he went to a POW training school before going to Vietnam!  The expression, “Thank you for your service.” is easy to say but true gratitude takes money. Just my opinion.

LadyTexan

What is IRMA?

Joe C.

LT, IRMAA (Income Related Monthly Adjust Amount) is increased monthly cost some people have to pay for Medicare Parts B & D. As ones Gross Income (not taxable) increases above certain thresholds the Medicare monthly payments increase. In my case since I am withdrawing funds from my IRA to pay for cost not covered by Medicare my gross income increased to a point where they increase my Medicare payment. It is not huge, but about an extra $1,500 a year  and it will get higher if I’m withdrawing more funds to pay for MC. It just irks me that I have to pay more for Medicare because I am paying health care cost they do not cover. One small tweak in the tax code would be the calculate IRMAA based on Gross Income minus Medical Deductions, in my opinion that would be a lot more fair.

Iris L.

Rennbird wrote:

  true gratitude takes money. 

This should be on a t-shirt!

It is also a great campaign slogan, for anyone who is interested in running for office.

Long term care insurance was initially part of Affordable Care Act, but it was dropped as being too costly.  Ironic, too costly for the government.

Iris

JJAz

Joe C. wrote:

JJAz, Thank you for your comment and I am well versed in to tax code. My angst arises from what is and is not being proposed by our political leaders. If they can propose things like universal child care then why not universal adult care, if you can have propose student loan forgiveness then why not LTC facilities cost forgiveness, if you can propose have free community college then why not government funded respite breaks. I feel we are a forgotten population. Yes, there has been hundreds millions of dollars of spending proposed for LTC for those who a Medicaid eligible but not a red cent for those who are self funding. I am not wealthy but worked hard and saved for a comfortable retirement but most of that will be gone by the time this journey is over. To be clear I am NOT a political conservative and feel there is merit in many of the current proposal but there is nothing in the trillions of dollars of spending to help people who are self funding care of LOs. As you are aware the cost of LTC easily dwarfs the cost of a college education, it would be nice if they at least threw us a bone.

Joe, I agree completely.  We too were self-pay for LTC before my DH died, running at an annual rate of near $100,000.  DH resided with several people in LTC whose costs were being paid by Medicaid and it was difficult to resist the temptation of resentment about all of the sacrifices we made over the years to save our money for "retirement" (of which we had none together). 

LadyTexan

Thank you Joe for explaining IRMA.

I am not in your situation. I wholeheartedly agree with your comments.

I have written to my US Senators and US Representatives about the financial impact of dementia related diseases on more than one occasion. I received responses from only two. One was a canned response, not even relevant to my topic. The other response was more tailored but noticeably vague regarding any actions.

I am in a better financial position than some, and a much worse position than others. We have electricity and enough food today. We do not have the resources to carry us through this illness. Like many in the EOAD boat, our careers were cut short. Our earning records took a heavy hit. This disease is expensive and it is exhausting. 

I was raised to be self sufficient. It is crushing me to realize I have met a foe that I am not prepared to take on. I saved money, but obviously not enough to carry us though. Many days I am overwhelmed. 

It is important for me to continue to tell the people in DC to pay attention to this very important issue and to TAKE ACTION. Alas, I have not been effective yet. I am not giving up.