The Poor Widow Scenario

To: Josh Marshall
Re: In Effort to Pare Medicaid, Long-Term Care Is Focus

You should read this. It appears to be the beginning of another stick it to the middle class bamboozlement. The majority of the article describes the need to recover more assets from elderly middle class people before allowing them to qualify for Medicaid for long-term care. Then we get to the last three paragraphs:

The dated notion of "Medicaid millionaires" giving away their money and draining the system was debunked last month in a report by the Health Policy Institute at Georgetown University. After an analysis of several federal studies, the report, written by Ellen O'Brien, found that people qualifying for Medicaid gave gifts of less than $5,000 on average, with a minimal impact on the program.

On the other hand, Dr. O'Brien said in an interview this week, there is compelling data on the typical trajectory to poverty from ages 65 to 85. In those two decades, Dr. O'Brien and others say, a healthy, middle-class woman spends considerable money on her husband's long-term care, is widowed and left to manage on the meager benefits of a surviving spouse, spends almost a third of her income on medical expenses not covered by Medicare, assumes she will never wind up in a nursing home and then does.

"That's the heart of the Medicaid story," Dr. O'Brien said. "It's the 'poor widow' scenario, and it's just horrible."

The effect is bizarre, perhaps reflecting a discrepancy between the current terms of the political debate (the opening) and the reality of the situation (the conclusion).