Stephen Moses took a thumping recently when he tried to testify at a congressional hearing on abuses of Medicaid eligibility rules.
Moses, who worked for the inspector general of the U.S. Department of Health and Human Services in the 1980s and is now president of the Center for Long-Term Care Reform, Seattle, spoke at a hearing on Medicaid planning organized by the House Oversight and Government Reform Comittmee's health care subcommittee.
Moses submitted written testimony explaining his argument that he believes the government should do more to reserve Medicaid nursing home funding for people who are genuinely poor, or, at least, not affluent, and keep people from using loopholes in Medicaid eligibility restrictions to shield large amounts of assets.
He made a great argument on paper, and, in the virtual world, the committee posted his testimony on its website, along with testimony from David Dorfman, a New York elder law lawyer who said he thinks reports about eligibility abuse are exaggerated, and that the real problem is that people who need help with paying for the cost of long-term care are not getting it because the rules are so complicated.
But the committee also posted testimony from Janice Eulau, a Suffolk County, N.Y., Medicaid administrator who said she sees couples with $500,000 in resources, and some with more than $1 million in resources, qualifying for Medicaid long-term care benefits.
We here covered the written testimony.
In the real world, at the actual flesh-and-blood hearing, Democrats on the subcommittee asked so many questions about the funding sources for the Center for Long-Term Care Reform that Moses never got to make his case out loud, in the form of spoken words.
Lawyers have an important lesson about how to proceed in life: When the law is in your favor, pound on the law. When the facts are in your favor, pound on the facts. When neither the law nor the facts are in your favor – pound on the table.
At the Medicaid planning hearing, Moses seemed to be standing in for the table.
Outside of hearings, Moses said during an interview, he tends to have a somewhat easier time winning over Republicans than Democrats, but he said he feels he has had a great deal of success with members and staffers from both parties.
"Nobody challenges my facts or my figures or my arguments," Moses said.
Democrats tend to be more sympathetic to the plight of families facing the cost of long-term care – which can be daunting even for families that have thought of themselves as being solidly middle class – but, Moses said, they tend to change their minds when he explains that, "The people getting those benefits are Republicans. They're the ones doing the Medicaid planning."
Letting a family with $500,000 or $1 million in home equity use Medicaid nursing home benefits, rather than requiring it to get a reverse mortgage or use other assets, is a form of estate protection that helps the affluent at the expense of genuinely needy nursing home patients and against the low-income and middle-income workers who help pay the taxes that fund Medicaid, Moses said.
