Gaming the System, Screwing the Country

It’s amazing but true: lawyers like Alice Reiter Feld in her newsletter, (Center for Asset Preservation and Long Term Care Planning, 5701 N. Pine Island Road, Suite 260, Tamarac, FL 33321) blatantly advertise how easy it is to shield, insulate and exempt assets from Medicaid spend down. Then the government (actually, we taxpayers) gets to pick up the tab for their long-term care (LTC) when people who follow Ms. Feld’s advice become eligible for Medicaid.

She writes, “At a recent meeting, the subject of nursing home care came up. One pastor in the group opined that, in order to get Medicaid to pay for such care, a person must have spent all his money. My husband (who’s been enlightened by his elder-law attorney/wife!) immediately corrected the pastor, advising him that this was not true. He then also advised him to get Nursing Home Medicaid advice from an elder law attorney.”

The truth is that Medicaid eligibility is riddled with loopholes, enabling many people to legally shield and divest their wealth, then get Medicaid to pay for their long-term care. I am all in favor of Medicaid-paid long-term care for those who are truly indigent. That is, after all, what Medicaid is supposed to be: a safety net for the poor. Nowadays, however, it’s taken advantage of by Medicaid planners like Ms. Feld, who make a nice living helping people with means gain access to Medicaid.

When people with home equity and other assets game the system as described, the federal government must find more revenue to meet the increased demand for Medicaid, which in turn increases our national debt or the tax burden on all of us.

Perhaps more importantly, Medicaid-paid long-term care is often very sub-standard. I strongly encourage Ms. Feld and her complicit husband, Rabbi Mitch, to visit a Medicaid-paid facility in a large city.  They can then provide accurate, detailed descriptions of the Medicaid-paid long-term care facilities their clients are planning to spend their final years in.  Perhaps Ms. Feld’s clients, including her husband, will consider alternative facilities before they divest and shield their assets.

Click here to see my recent article describing what Medicaid-paid nursing home care is like.

To Ms. Feld: I know you are making a good livelihood doing Medicaid planning, but I encourage you to expand your practice to other areas. You will sleep better. To me, you are a “bottom feeder,” doing what is legal, but is it ethical?  To your husband and others enthusiastic about this approach, I urge them not only to consider the ethics of saddling the US taxpayer, including themselves, with the bills for this slight of hand, but also to become better educated about the lack of options and poor quality that have unfortunately become synonymous with Medicaid-paid LTC.