Archive for Thursday, September 30, 2004


It doesn’t seem unreasonable for the state to try to recover from Medicaid recipients some of the costs of providing their medical care.

September 30, 2004


What should we expect from our government?

In some cases, Americans' idea of what they are entitled to in the way of government services seems a little out of whack.

A state law that takes effect Friday apparently has triggered a fair amount of concern and criticism from people who receive state Medicaid payments. The law allows the state, under some circumstances, to claim assets from Medicaid recipients or their estates to help recover some of the cost of paying for their care.

An example of this is a 50-year-old Prairie Village man who has been receiving Medicaid payments for many years as a result of injuries he sustained in a fireworks accident in 1977. He can't work but was able to purchase a house after the accident using a lump sum payment from Social Security and had hoped to leave the house to his niece and nephew upon his death.

Now, he has been notified that the new law will allow the state to place a lien on his house so that any proceeds from its sale can be taken by the state to cover some of the costs of his care. In response to this news, the man said he felt he was the kind of person Medicaid was meant to help without any expectation of getting paid back and asked "Isn't Medicaid supposed to cover the poor without holding them hostage?"

There is a distinction to be made here between help and a handout. Given that Medicaid is paying more that $1,000 a month to supply prescription drugs for this man, the amount paid for his care almost certainly already far exceeds the value of his home. Why is it unreasonable for him to have to repay the state using whatever assets he has left when he dies or leaves his home?

There are many exceptions to the law. It only affects people who are 55 or older or who receive long-term care services through a nursing facility. For married people, any seizure of assets would be delayed until after the death of the person's spouse. Funds also couldn't be recovered from an estate that involved a minor child or a child with disabilities. The goal is not to leave anyone destitute, just to use whatever assets are left over to help the state meet its ever-growing Medicaid demand.

Medicaid is an important safety net for low-income Kansans, but the money to support it doesn't fall from heaven; it comes from taxes paid by hard-working Kansans with homes and medical costs of their own. Because we, as a state and a nation, think it's important to take care of those who are less fortunate, we fund Medicaid so people can receive needed medical care and, in some cases, continue to live in their own homes. It's not reasonable, however, to expect taxpayers to also provide an inheritance for a Medicaid recipient's family.

Where did we get the idea that we're entitled to have someone take care of us, whether that means providing medical care or even preserving our inheritance? Repaying the state or any other entity that has taken care of us in a time of need just seems like the honorable thing to do. It's almost too bad it takes legislation to force people to do the right thing.

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