F. Bentley Mooney

When Health is Lost F. Bentley Mooney

In the mid-1980s, Congress became aware that many -- almost one out of seven -- worked hard, lived frugally, succeeded in establishing a dignified standard of living as retirement age approached, only to have that independence destroyed by the costs of long term care. To reach out to those left penniless by this blitzkrieg, Congress added several provisions -- optional to the states -- by which to become eligible for long term care under Medicaid without total loss of economic security. These provisions authorize certain transfers and do not count certain resources. The new provisions were added expressly to permit eligibility without spend-down, even permitting avoidance of lien recovery for benefits paid. All levels of government experienced continuing budgetary stress over the 15 year period ending in the late 1990s. During that time, characterization of these broken seniors shifted from 'fine Americans, humbled by unfortunate circumstance' to 'greedy geezers feeding at the public trough.' But Congress has seen fit to leave the eligibility planning rules in place. We must therefore assume that the criticism is for public consumption while the real policy remains one designed to meet these serious social needs.