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Chapter 13. Medicaid

Chapter 13. Medicaid

Medicaid is the only public benefits program that pays for the cost of long-term care in a nursing home. It was never intended by Congress when it was first passed to be the primary provider of the cost of nursing home care for so much of the elder population, but the combination of more and more people living to older ages and the costs of nursing home care increasing so much has contributed to Medicaid’s prominence for many older Americans.

Over the last 20 years there have been many changes in the Medicaid program, done more, it would appear, in an effort to reduce costs than to increase the effectiveness of the care provided. In particular, Congress passed the 1996 Kennedy-Kassenbaum law. This law originally contained a provision that made it a crime for lawyers to advise clients about perfectly legal efforts that could be taken to deal with assets in order to make their clients eligible for Medicaid benefits. This provision of the law was challenged and found to be unconstitutional, but it still reflects the thinking of many in Congress, which is to avoid the massive, creative reform that is needed to meet the cost for long-term care in nursing homes in America and instead focus on how a flawed Medicaid program can keep its costs down.


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