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Archive for March, 2017

What does Medicaid Reform mean for You?

Posted on: March 10th, 2017 by Mark R. Friedman

The United States is rethinking how it pays for healthcare.

There has been a lot of public discussion about the fate of the Affordable Care Act – whether it will be repealed, and if so, what its replacement (if any) will look like.  There has been less discussion about something related that may have an even greater impact on Americans – Medicaid reform.

Medicaid is a joint federal and state program that pays for healthcare for people who meet its eligibility requirements.  That means that Medicaid is paid for by both the federal government and the individual states that administer it.  For example in New Jersey, Medicaid is regulated and managed by the state Department of Human Services, and the funding comes partially from the New Jersey state budget, and partially from the federal government.

Since its inception in the 1960’s, funding Medicaid has been an open-ended commitment from the federal government.  Federal and state governments set rules on who was eligible for Medicaid, and the United States committed to provide enough funding to pay for every Medicaid beneficiary’s cost.  There is no limit on how much the federal government will spend on Medicaid, it simply pays (with states) for everyone who qualifies.

Now, that may change.  There is a proposal circulating now to change Medicaid funding to “block grants,” where the federal government would provide a fixed amount to each state based on that state’s Medicaid spending in 2016.  This would almost surely result in the federal government providing less money to states to fund Medicaid.

If that happens, states would either have to raise taxes, cut spending elsewhere (like schools and roads), or cut spending on Medicaid.   Or maybe all three.  If the cuts to Medicaid spending get drastic, the government may impose drastic measures, making it more difficult to qualify for Medicaid or preserve assets for other family members.  There is already a bill in congress to limit lucrative Medicaid annuity planning.

Point being, if you or a loved one may need Medicaid, and also want to preserve assets within your family, it may become harder to do so in the future, so it would be wise to start thinking about that now.

For more information on Medicaid planning and your specific situation, call or email FriedmanLaw today.

Will our Future Caregivers be Robots?

Posted on: March 3rd, 2017 by Mark R. Friedman

America has an aging population. As the baby boomer generation grows older (and wiser) and lifespans continue to increase, more and more people are going to need long term care. Today, long term care is invariably provided by humans – by family members, home health aides, and staff at nursing homes and assisted living facilities.

But how much long term care can be provided in this manner? Taking care of a family member is difficult, and often takes a toll on the caregiver’s own health and productivity. Professional caregivers are expensive – home health aides often cost around $25 / hour, and nursing homes commonly cost more than $10,000 per month. At FriedmanLaw, we often help families figure out how to pay for long term care, with Medicaid and other resources. But as the population of people who need long term care grows, there may come a point where there simply aren’t enough caregivers.

Providing long term care to everyone who needs it will require creativity. One of the more interesting solutions is robotic caregivers, which are being developed by companies across the world. It may sound like something from a bizarre science fiction movie, but in the near future, robot caregivers in people’s homes may be able to administer medication, check vital signs, teleconference doctor and family visits, assist with mobility, perform household chores, and even provide companionship. Robots may replace human caregivers, or allow human caregivers to care for more patients in less time. Robots may allow people to stay in their homes longer instead of going into long term care facilities.

I’ll leave the technical aspects to other people. But from a legal and financial standpoint, an obvious question arises: Who’s going to pay for all these robots?

If a robot caregiver prevented someone from going into a nursing home, it would save tens of thousands of dollars per year. Often, much of that cost ultimately falls to the government, through the Medicaid program. So the government may determine that it’s cheaper to provide robot caregivers to people, and include robot caregivers as a benefit under Medicare. Perhaps insurers also would pick up the tab, if robot caregivers prevented emergency room visits. It’s a potential gold mine for a company that can develop a practical, useful robotic caregiver, with a huge market and a deep-pocketed buyer.

Robots certainly can’t take care of everyone. Some people have demanding, constant medical and safety needs, and the only safe setting is a nursing home or assisted living facility. And of course, people are scared of robots. Robot caregivers would have to be developed with whom people feel comfortable. But if robots can be created that alleviate some of the need for human caregivers, that would be a major step towards solving a looming problem.

In the mean time, if you or a loved one may need long term care in the future, contact FriedmanLaw to discuss care options and how to pay for them.

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Homepage photo: Cows grazing at Meadowbrook Farm, Bernardsville, NJ by Siddharth Mallya. October 23, 2012. http://en.wikipedia.org/wiki/File:Autumn_Leaves_13.jpg.
Interior photo: Somerset hills pastoral scene by Lawrence Friedman.