Obamacare's Medicaid Clawback Is Only Shocking Because the National Press Has Ignored It

Beginning early in 2014, shortly after its initial disastrous rollout, there has been a virtual blackout on anything resembling negative coverage of the "Affordable Care Act," aka Obamacare.

It hasn't been due to a lack of horror stories: plan cancellations, shocking rate increases, shrunken provider networks, co-ops going out of business, etc. It's because the nation's establishment press has worked mightily to minimize their exposure and to avoid dealing with their larger significance, calling them "glitches," "tricky situations" and the like, while mostly ignoring individual local nightmares. Now several Minnesota residents, clearly kept in the dark until now about something yours truly and several others on the center-right warned of in late 2013, have learned that Obamacare has saddled their children with tens of thousands of dollars in debt.

As informative as the following local TV report is (HT Hot Air), I believe that it misses a critical point — namely that, unless it's been changed since late 2013, families in the situations described, if they apply for insurance through HealthCare.gov, or in this case through the web site of the Minneota state exchange, are forced into the Medicaid program, and cannot go back and refuse the "free" coverage:

Here is most of the TV station KARE's accompanying text report, which mostly tracks the video:

MNsure enrollees shocked by estate claim

Some Minnesota families are calling out MNsure. They thought the healthcare plan they signed up for would save them money.

But they say, as it turns out, it will leave their children "tens of thousands of dollars" in debt.

And they say those real costs - weren't disclosed to them at first.

Rick Rayburn and his friends are suffering from a severe case of sticker shock.

“Disbelief. Just absolute disbelief,” Rayburn said.

The Pine County residents thought the Affordable Care Act could save them money.

They looked for a new health insurance plan on the state's MNsure website.

“I'm not the person looking for something for nothing. I'm looking for a reasonable price,” Rayburn said.

Despite owning land and homes, their income and ages made them eligible for Medical Assistance -- Minnesota's version of Medicaid. They were told their monthly premiums would be zero.

“Getting it for nothing did not sit well,” Rayburn said.

Then his friend Scott Killerud said he read on a mailer that it was too good to be true. Anyone over 55 on the low-income plan who owns property will pay. Eventually.

The state is picking up the tab now. But their children will have to pick up the tab after they die, in the form of liens. There would be no bill for the children if their parents have no assets in their estate, such as land, a home or retirement accounts.

Rick asked the Minnesota Department of Human Services what his kids would owe.

“Called them up and they were more than happy to tell me we owed them more than $30 thousand,” Rayburn said.

Scott's children will owe $11 thousand. And the children of Julie Gelle from Sandstone will owe $16 thousand for less than two years of coverage she never used.

“I did not go to the doctor once,” Gelle said.

“The smallest one we've seen is about $6600. The highest one we've seen tops $80 thousand,” Rayburn said.

Let's stop there to explain how all of this has come about, from a column I wrote in late November 2013. Hang in there until the final paragraph to see why Julie Gelle wasn't making things up when she told of being charged even though the "did not go to the doctor once"  (links are in original; bolds are mine):

The Affordable Care Act eliminates Medicaid’s asset test, and creates the roach motel of government welfare programs. Medicaid is no longer an “entitlement” you can choose to access. Instead ... if you qualify under its new, lenient rules, HealthCare.gov forces your enrollment.

... So Medicaid is now mandatory for those who apply at HealthCare.gov and qualify — and as long as your income remains sufficiently low, you can never leave.

Beyond that, with the asset test gone, the web site forces even well-off households into the program, as long as their “Modified Adjusted Gross Income” is at or below 100 percent of the poverty level in states which have chosen not to take federal bribes to expand the program, and 138 percent in states which have.

... If you really think this is entirely the result of government incompetence ... you haven’t heard of Medicaid’s Estate Recovery Act, a measure which requires states to claw back money spent by Medicaid from available assets in deceased beneficiaries’ estates.

Many people believe that this act only relates to nursing home and long-term care expenses, but that isn’t necessarily so. States “have the option of recovering the costs of all Medicaid services paid on the recipient’s behalf.” My tentative research indicates that roughly half of all states (Minnesota is one of them — Ed.) pursue recovery of all costs. Thus, it appears that a person’s estate will be liable for all Medicaid costs incurred while he or she and all other family members were enrolled in the program.

There’s more. Some states pay managed-care providers in some or all of their Medicaid programs on a “capitated” basis, i.e., a flat dollar amount per person per month. It appears that the estates of Medicaid beneficiaries in certain states are required to reimburse the government for capitated payments made — even if no medical services were rendered.

Based on what Julie Gelle told KARE, Minnesota would appear to be a "capitated basis" state. Her children are on the hook for $16,000 so far. Unless she has been able to refuse coverage and find it elsewhere outside of Medicaid, that figure will continue to grow, whether or not she ever visits a doctor.

I have not found anyone I have informed of situations such as these who isn't totally outraged when they learn of them.

But that's the problem. If they're lucky, people find out about this government-driven grand theft scheme from the relatively few people who have stumbled across it. Everyone should know about this — and they would, if we didn't have a national establishment press which refuses to report anything which might make government-run health programs look bad.

Cross-posted at BizzyBlog.com.

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