If you spend time living in a nursing home, the Medicaid agency that assists in paying for your stay will look for a way to recover the costs of your nursing home stay. When you die the agency has the option to recover the proceeds from your estate, the process is known as estate recovery.
Join us to learn about the MassHealth estate recovery process (where the state agency claims reimbursement from real estate or a probate estate) and the “Stop Unfair Medicaid Recoveries Act of 2022”, which was introduced in the U.S. House of Representatives and is meant to limit estate recoveries. We will be joined by guest speakers, Attorney Jim Schuster of Southfield, Michigan, and Attorney Timothy R. Loff from The Law Offices of Timothy R. Loff of Newton, Massachusetts.
In this webinar we will be covering:
- How can MassHealth recover from your estate?
- What happens when MassHealth places a lien on your home?
- How would the “Stop Unfair Medicaid Recoveries Act” limit a Medicaid agency’s power to recover from estates?
The opinions expressed in this webinar are the opinions of Attorney Brian Barreira, Attorney Timothy Loff and Attorney Jim Schuster on the law as written as of the date of the webinar recording, July 21, 2022. The information presented in the webinar is for informational purposes only, and is not a substitute for individualized legal advice.
Brian: This webinar is about estate recovery we’re gonna talk about Massachusetts and federal laws. So, I’m Brian Barreira I practice elder law and estate planning in Plymouth, Massachusetts. With me is Jim Schuster from Michigan and Tim Loff, Tim go ahead tell us about your practice.
Tim: Okay my name is Timothy Loff, I’m an elder law attorney and practice in Newton, Massachusetts. I do a lot of the same stuff Brian does, estate planning and elder law. I do quite a bit of probate work as well which is why he wanted to bring me in here to do some talking about estate recovery because I do quite a bit of work with the state recovery and probate and medicaid as well as applying for medicaid as well as dealing with estate recovery after a medicaid issue or we call medicaid MassHealth here in Massachusetts but that’s basically the same idea of medicaid.
Brian: And Jim, did they call it medicaid in Michigan?
Jim: Yes, in Michigan it is medicaid, simply medicaid. A matter of fact, I am mostly retired right now so i have time to pursue these other let’s say pursuits and I joined NAELA in 1995 and I took off with elder law from then and most of my practice was devoted to processing medicaid applications and helping families get through the maze of medicaid and I think we helped a lot of people over the years. And one thing, my clientele once again was a working family clientele, not a low income clientele, but a working family clientele and that’s where I come to the issue of estate recovery because I developed a personal animist about it, we can talk more about that later. i think Tim should go number one.
Brian: Okay, so let’s get started with what is estate recovery? Estate recovery, when you apply for medicaid most of your assets are up for grabs, generally speaking, it’s a little less so with spouses but your assets are up for grabs. Sometimes something is left behind and after you die estate recovery is the process where the state medicaid program comes back at you and tries to get what’s left from your estate. In some states they can go after anything, in Massachusetts they can only go after the probate estate, at least that’s the current state of the law. So, let’s go over what’s the estate recovery process in Massachusetts, Tim.
Tim: Yeah, well typically you know because what happens in Massachusetts primarily is that the only asset that you really can have and be eligible for long-term medicaid, in most cases, would be your primary residence. So, it’s not a situation where you could have a vacation home or something like that, that would be secondary. So, what happens, as a practical matter, is the federal and the state law require Massachusetts MassHealth program to try and recover assets when somebody dies and in this case the asset would be real estate. So, the idea would be they are supposed to by law, federal and state law, they are supposed to basically try and recover the value of the benefits that they may have paid out from the probate estate as Brian said. And this in most cases would only include real estate at the point in time where somebody would die that has been on MassHealth at that point in time. The idea would be there’s two, essentially two kinds of estate recovery things that happen, the first is what’s called a lien, under the what we call the Tax Equity and Fiscal Responsibility Act of 1982. Basically, Congress said that liens can be placed on estates against real estate owned by the person who received or receiving MassHealth during their lifetime, when the person is three things (1) institutionalized, (2) receiving long-term care, being paid for by MassHealth, and (3) not reasonably expected to return home. So, in the event that any of those things have happened then you’re going to be in a situation where upon death MassHealth is going to try and collect some money. Now the lien basically is intended to go on the real estate and prevent the real estate from being sold without MassHealth being repaid during the lifetime of the person that’s in the nursing home or the institution. So, the idea would be that lien is only a lifetime lien they only call it a lifetime lien because essentially it ends upon somebody’s death. For that lien to be put on somebody’s estate, first of all the MassHealth has to give notice of the fact that they’re going to do a lien they, have to give an opportunity for a fair hearing before the MassHealth board of appeals to decide whether or not that lien is appropriate and valid. Assuming that they have received advance notice and they have not objected then the lien will be placed, it’s recorded at the local registry of deeds and becomes a lien against the property. Now, if this real estate thereafter is sold or transferred or refinanced, any proceeds that are obtained while the person is still alive from the selling or the transfer or the financial have to go back to use to pay back the state, which is why the lien is on there.
Brian: And that lien is a vestige of the old law where up until about 1990 you could transfer your home even if you were in a nursing home you could give it away. But so the lien was to prevent that.
Tim: Right, exactly.
Brian: But MassHealth is is now arguing that the lien stays intact and survives death.
Brian: I have a land court declaratory judgment case right now that’s going forward on that issue. They really have very little to go on in their brief.
Tim: I can’t imagine how they could make that position be very substantial because really the lien is a lifetime lien that’s what TEFRA said so it seems ridiculous that they would pursue that. But then as we know, MassHealth tends to pursue a lot of ridiculous positions, so.
Brian: Yeah, well and we’re used to it.
Tim: Yeah, exactly.
Brian: You know, Jim, you probably had it easy in Michigan. We’ve got lawyers here who will just make unbelievable claims. You know, there was one claim regarding a trust that they once argued that a trust was countable because the kids could get the money out and buy a sports car and let their mother, who’s in a nursing home, use it and the use was, you know, a distribution from the trust. It’s ridiculous, they will make anything up around here. Well, go ahead, Tim, keep going.
Tim: Yeah, we raised the whole issue of a lien because I think there’s a lot of confusion in Massachusetts among lawyers and individual people who aren’t lawyers about the difference between a lien and a claim. So the lien basically goes on the real estate when somebody’s still alive, they’re in a nursing home, they’re receiving benefits, they basically have no intent to return home, that’s when the lien gets put on the real estate. But technically, I believe, and I think Brian would believe that lien is supposed to end upon the death of that person that’s been in the nursing home and upon death that lien is basically gone, but now, MassHealth has the right to make a claim against only the probate estate. Now, the reason that there is a probate estate in these situations is because MassHealth will not allow you to put a house in a particular like a living trust or anything that would, like joint property or something that would avoid the potential for MassHealth having a lien in order to be eligible for MassHealth in the first place. So the idea is now you’ve got this property it’s in your own name, when you die the only way that you’re going to be able to transfer title to that property to your heirs or the people that you leave in the will or whatever is by going through the probate process in Massachusetts. So, once you hit that probate process now MassHealth has the right to make a claim against the estate which they file in the in the court and which basically must be taken care of before the property title would be cleared. So, that’s the whole way it works as far as a mechanical situation. They would actually, what happens is that upon the person’s death under Massachusetts law you have to actually file a notice with MassHealth in order to probate the estate and it doesn’t really matter whether it’s, what size of the estate or anything else, but if you’re going to probate it you’re going to have to file a notice with MassHealth. Upon receipt of that notice, if there is real estate if they do believe that they have a claim against that real estate for the benefits that have been paid to that person, which by the way would include benefits paid over 55 and benefits paid to through a nursing home if you’ve been institutionalized, so they can get benefits paid through either of those directions. So, in the event that they’re going to make that claim what they have to do is they have to send out a notice of claim. That notice of claim will say that you’ve got 60 days to object to this notice, if you don’t object to it then basically they’ve got the right to move forward and collect that money regardless. Typically, you have the right to ask them for a detail of their claim and they will send out some kind- of they used to send out cds i don’t know what they’re sending out these days- but they used to send out detailed information, and to the extent that it was good to get that, it is very good to get that because a lot of times there are things in there that they’re not really entitled to be getting and they’re still trying to get it. So, the scary thing in Massachusetts is that can include just about anything that MassHealth had puts their fingers on during lifetime. So, I’ve had clients that have had meals on wheels that have showed up in a medicaid claim. You know, so it’s just about anything that they’ve put their little fingers on that they can try and collect so it’s a lot. So now, once that claim comes in you do have the right to object to it, if you don’t object to it, then 60 days later it’s going to be deemed done and then at a certain time after that they’re going to start charging interest if it’s not paid. They’ve actually, my experience has been they’re pretty good about that, if for some reason the house hasn’t been sold or there’s no money in the estate to pay for the claim outside of the sale of the home, they’ll be pretty good about waiving the interest or at least not giving you too hard a time about that. But, I think generally speaking in Massachusetts the estate recovery division of MassHealth is a lot easier to work with than the medicaid eligibility side of MassHealth, they’re just nicer people and generally they’re not gonna give you much room to negotiate, in fact there’s no room to negotiate because they will say that they are mandated by the federal government to collect this estate recovery. So, in the event that you do object it’s not going to be MassHealth you’re going to be up against, it’s going to be the Attorney General’s Office in Massachusetts because they’re the ones that are turned over for purposes of collection and I’ve been litigating the objection that you might have to it. So, in most cases trying to object to it based on, ‘well that’s ridiculous amount of money’ or ‘you shouldn’t be able to collect that’ or whatever is not going to get you very far. There are a bunch of things that can be done to try and take care of these, what we call exceptions or deferrals in the MassHealth world so that basically you can either put off the collection of those funds or you can actually have those funds waived altogether. Deferral is the first level, deferral is an interesting thing because we’re really not sure what that all means in the extent of things, we know that basically the deferral under the law says that the repayment of the claim will be deferred if there is a spouse, a child under 21 or a permanently disabled child living in the residence at the time of death of the person who has been getting the MassHealth benefits. Deferral is not clear, you know does that mean until the spouse dies if there’s a spouse in there, does that mean until the child you know hits a certain age, what happens is the property is sold in the meantime? So there’s a bunch of questions about the deferral portion of this thing that really have not been answered and we’re still trying to wait and find out some clarification on that one. The second area is an actual hardship waiver and that’s where the actual claim for MassHealth will be waived by MassHealth. This has been something that’s come up, it’s been in place for a while there’s been some ways to get waivers but they’ve recently, due to some litigation that was filed, I think Brian you were involved in some of that creation of that litigation, that litigation basically that was filed scared MassHealth as well as the possibility that they might end up with some actual law that would change it. So, they’ve gotten a little easier on their waivers in the last year or so. The hardship waivers there’s three basic hardship waivers that you can that you can apply for, one is a residence and financial hardship and this is where if a person was living there as their primary residence for two years before the member’s death and they happen to have, they’re not being forced by the heirs to sell the property, and they happen to have income below 133 percent of the federal poverty level then basically the hardship, if they meet all those requirements, then basically there’s a hardship waiver in place and MassHealth arguably will waive the claim altogether, no matter what the value was. This waiver used to be a two-year conditional waiver, so the person basically had to have income 133 percent below and all those other things had to be in place for two years after the person died then that waiver would be permanent, but now it’s permanent, arguably, if you fit all those requirements at the time of death. So, the second one is what’s called a care provided waiver and this is same situation you know, someone was living there for two years prior to the person’s death. They inherited an interest, whether it was an heir or under a will or something else, so they’ve got an interest in the property, they’re not being forced to sell by anybody else, by any of the other heirs or anybody else, and they arguably provided a level of care for a period of two years prior to the person applying for MassHealth that kept the person out of a nursing home. So, we have in Massachusetts this caretaker child exemption from the original application if you’ve taken care of your person for two years and that person ends up in a nursing home but you’ve kept them out of the nursing home for two years prior to that you can actually have the house transferred to the caretaker child. This is a post-death caretaker waiver, so it’s accomplishing the same thing but it’s post-death. I’ve just had my first one I just filed it a couple of weeks ago we’ll see how it goes. I have heard from people that it’s actually working, that they have had the conditional waiver provided. It’s a tough one because you’ve got to have a doctor that’s willing to go back from the date of death, go back all that time prior to be able to say that in fact, in his opinion, the person that provided the care kept the other person that’s [receiving benefits] from Medicaid out of the nursing home for two years. So, as long as you’ve got a doctor able to do that in my particular case the doctor had retired but he was willing to come back and make that statement in writing, so I think that’s something you’re not going to find very often, so it’s not going to be used very often but I think it is something that’s certainly available if you can do it. And then the final one is a little weird, it’s called a financial hardship for heirs waiver, so, again if you’ve inherited an interest and your gross income at the time that the person died that was on MassHealth is below 400 percent of the federal poverty level then you can get a waiver of up to $50,000 per heir or $100,000 total and that’s basically where that one is available I’ve never seen that one used yet we’ll see how that one goes that’s that’s an that’s an interesting one in terms of the values and how it works. Supposedly if you’ve got you know let’s say you had three heirs you’ve got $150,000 and all three heirs were below 400 percent and met the requirements arguably if the claim for MassHealth was more than that MassHealth gets the difference. so it could be a complete waiver depending on the size of the MassHealth claim. I guess the last thing Brian that you wanted to talk about briefly was the long-term care waiver for estate recovery in Massachusetts if you have a long-term care insurance policy that will pay at least $125 per day for at least two years and you have that policy in place at the time the person goes into the nursing home, meaning that you could have used some of the benefits but you got to have some benefits left at the time you go into the nursing home, then technically even though that policy might be used for nursing home care while you’re in the institution, upon your death the property is waived for any estate recovery. It’s a Massachusetts only exemption, has not been used a lot but it’s there and it’s something you know as long as you purchase the policy and you’ve got the minimum $125 a day for two years even if you use it for home care as long as the policy is still in existence and you haven’t used it all or it hasn’t terminated at the time you go into a nursing home that will protect the home. Again, it will only protect the home but it is, you know, something that we’ve certainly used before for this purpose.
Brian: But I can just see a MassHealth lawyer arguing that there’s not enough left on the policy when you went into the nursing home.
Tim: Well you know what, when this law was first passed you may probably remember Deborah Thompson
Tim: So, Deborah Thompson was a lobbyist for MassHealth or for Mass NAELA which is our organization, that is organization of elder law attorneys here in Massachusetts and when this law was passed she and I queried MassHealth about that very issue. It’s like well wait a minute now you know you say a policy is going to be in place how much has to be in place and we got a letter from MassHealth that we are hanging on to for dear life that basically says that any amount, so arguably we would use that to fight against them if they were to ever say something otherwise but as you know Brian they’re going to say what they’re going to say.
Brian: You know, it just seems to me that if you’ve got $125 per day on your policy that doesn’t cover a day-
Brian: -in a real nursing home so maybe you need to have enough to cover one day in a nursing home.
Brian: You know, so maybe you gotta keep $600, you know or something like that on the policy or $500, four or five days worth. I don’t know, I could see them finding a way to get around what the law seems to say.
Brian: So, there are a couple other estate recovery things we think we should mention, the $25,000, they don’t go after if the probate estate is under $25,000, and then they cannot go after a late and limited probate. Which is one that is begun three years after death, we had the top court in Massachusetts ruled on that and I think they’re watching now for, and they will file before the three years are up and if they’re aware of an estate that they might have a claim on. So, it’s not something you can really rely on.
Tim: Yeah if the heirs don’t file a probate and think maybe well if we wait three years maybe we’ll get away with it or don’t file a probate just because nobody knows what they’re doing, MassHealth can file their own probate.
Jim: Yeah, by the way that’s true in Michigan, but Michigan department does not have any unit that files probate, so our standard operating procedure is to wait three years and file and have a good time.
Brian: Okay, so I think that’s probably enough about Massachusetts estate recovery right now. They are using the lien on real estate as leverage for their claim against the probate estate. So typically, they even though they’re required to remove the lien they’re not removing the lien and they remove it when they get paid from the probate estate. So it’s, but I’m sure we’ll be taking care of that within the next year or so I’m sure the the court system will rule that the lien is invalid. The land court already ruled once on that a couple of years ago but that case didn’t go to judgment and it never got appealed so it’s just it’s a legal non-entity at this point, but that’s why I filed in land court though because land court already ruled that the lien is invalid after death and I’m going for a declaratory judgment there and hopefully we’ll have that within a year. So, Jim, let’s talk about the Stop Unfair Medicaid Recoveries Act-
Jim: Exactly, now this is a surprisingly unknown bill that’s pending in the congress right now, filed by representative Jan Schakowsky out of Chicago, Illinois, which would terminate the entire estate recovery program. And it’s surprising that almost nobody knows about it, not the elder law bar, nobody. There’s only 15 co-sponsors, I can’t explain that but by and large, I’ll just go into a little bit of estate recovery, why do we have it, where did it come from and what’s wrong with it, and Brian how much time do we have, I don’t want to-
Brian: just go and we’re just doing our whatever today, we’re just going over, we’re already over our time, a half hour flies, but go ahead.
Jim: Here it is, well, wait a minute, half hour it takes me that long to introduce myself. Why do we have estate recovery? Well, essentially we know that it came out of 1969 the original medicaid act and the conception was that is a sort of a hand up not a handout, perhaps a you know a riff on the old new deal program of Franklin Delano Roosevelt. But then it was at that time conceived as a poverty program, helping the poor people and if they have anything left when they die, well we gave it to them we should get it back. However, that voluntary program of estate recovery became mandatory in 1993. Now, there is primarily one I would say huge driver and there was a GAO accounting, you know the GAO accounting office came up with a study saying that they could recover, estates could recover essentially 40% of their long-term care budget if they enacted and pursued estate recovery. Well then, you know that was 1989 the report came out, by 1993 we had characters like Newt Gingrich saying that, ‘why should we pay for people who don’t take care of the house, just drink hard liquor all day and then apply for medicaid,’ of course there was the long-term care salesman and if you recall in the 90’s long-term care was kind of the hot product all the insurance companies wanted to jump on it and Stephen Moses was everywhere touting the benefits of long-term care insurance. Trouble is that the policies, the premiums exploded, by 2010 there’s only 15 companies still servicing long-term care policies, it just didn’t work nobody can afford it. So, you know that’s the why we have it, what is it what does it mean, and I think Tim and Brian you’ve imply completely what it means, but let’s just get down to brass tacks, what we’re talking about is not a low income program. This is always described as a low income program, it is not. You can be high, super high income and if you can afford the monthly cost of a nursing home you know you got to wonder what are you doing in a nursing home, have your own private staff at home. No, this is really, estate recovery when you talk about somebody has a home you’re talking a working family, you’re not talking about a poor family who’s never had anything. Though, by the way let’s give a tip of the hat to the poor family communities, there are some who do have homes maybe they inherited from grandmother and why are we trying to help poor families on one hand and take away from them on the other hand which estate recovery does. Now, I’m going to briefly depart from my standard remarks and let’s just call it what it is, estate recovery is a tax, it’s a tax on the decedent’s estate. Now, I’m saying tax because what is a tax, it means you’re paying for government services, right, you know military, roads, bridges, schools you name it, fire, police you know that’s what taxes do. Now, we know that there is, as Tim has indicated, there is zero exemption for medicaid recovery, not a penny, not a dime. But let’s look at the poor rich people, let’s look at the millionaire farmers, let’s look at the multi-millionaire business people, you know there’s this thing all of us lawyers call the federal estate tax, pardon me, some of us lawyers call the federal estate tax, what is it, the transfer tax for the tax guys, but in that realm there is an exemption of over $12 million from federal estate tax. So, here you have working families get their home taken away and the millionaires get to save $12 million before they pay a penny of the tax. They go what, what was the rationale? Well, they came up with the rationale that the poor rich kids, and by the way it isn’t, the design was to protect inheritance, it’s plainly right on the committee reports in 2003. Sorry about the phone going off. In the reports saying they were going to protect inheritance, why, because family farms and businesses needed that protection to continue their profitable business. Without it they would, you know, have to close the business and go away. That is true of families, now why is that your families? If you pay you know attention to let’s say some of the public policies out there in the 21st century, one thing you and I have heard over and over if the United States workforce is to be competitive in the global economy we’ve got to have an agile, skilled workforce who’s not going to do one job you know they graduate from high school get a job and then you know retire from the same job, those days are long gone they got to be agile, which means they got to learn new skills and how they learn new skills? They got to have time and money, time to go to community college, money to pay for school. That’s beginning to sound an awful like capital, the millionaire poor billionaire business owners need capital to run their business. Well, the working families need that too to be competitive in the 21st century and we could just imagine for a very brief moment what if we have a lady who’s a single mother raising three kids she’s working at some retail place and she’d like to get a better job maybe in the medical field, whatever, but she can’t take time off work, she has no money for school, what if she got a mere fifty thousand dollar inheritance? See, think about that just for a minute a little inheritance can make all the difference in a working family, yet we take it away from them if mom had to go to nursing because she got Alzheimer’s. So there’s- that’s to my mind one of the most powerful reasons why we should terminate this thing and that’s what the Stop Unfair Medicaid Recoveries Act does. Now, the other part of it, let’s get back to the reality, let’s look at community deterioration. What incentive does any family have who’s going to lose their home to the state, to pay- what incentive do they have to pay taxes to maintain, to take care of the home, to insure it? There is none because all that money is going to be lost anyways, so why should they maintain the home at all? It promotes community deterioration. The other parts of it is, let’s compare to other programs, let’s just say okay working families dad got Alzheimer’s, too bad that’s the way it goes, you know it’s a roll of the dice, let’s look at the other program that affects seniors: long-term care. You know seniors how about medicare? When you look at medicare and for example the Kaiser Family Foundation published a study and one of their parts was that if you look at knee surgery, which you know it’s major event in person’s life but certainly not life or death surgery, that cost can be from 50 to $100,000. Now, in a state like Michigan, believe it or not, that would cover a year’s worth of long-term care. How’s that? I’ll just give you brief numbers – in Michigan the average cost of nursing home for Massachusetts is cheap it’s only $10,000 a month but that’s retail, we know medicaid pays wholesale, so what if medicaid pays $8,000 a month but don’t forget now we have there’s a patient pay amount. Well what if the patient is let’s say a widow or widower has a $2,000 a month income, that is their co-pay, so what is medicaid paying $6,000 a month $72,000 a year. Does medicare ask for anybody to pay back the money for the surgery you got? Not a dime, not a penny. Well but some people say, ‘wait a minute, wait a minute there’s a FICA tax, I paid for medicare all my life of course I’m you know, they’re not gonna, I paid for it already.’ Well, here’s a little secret, a person with no work history can purchase medicare right now, Medicare A, for $499 a month. By the way, there’s still no payback, okay. So there is, you know I could go on as any lawyer could on and on about why this medicaid estate recovery is just bad policy, ill-conceived based on erroneous assumptions, and by the way I told you earlier they remember that they estimated they get 40% you know, their money back long-term care- there’s a study by the group called MACPAC medicaid and CHIP, a medicare and CHIP, you know program that advises congress. So they did a big study in 2018, nationwide, and you know what the average to recover they got in states? 0.5% of their medicaid budget, not 40%, 0.5%. So, almost nothing at all, the program wouldn’t even change if they didn’t get that money. But, here’s the other thing, 46% of the people in long-term care nursing homes have Alzheimer’s or other dementias. That’s what we call in the business custodial care, medicare won’t cover it because it’s custodial care. Well we know, not just because they’re lawyers but anybody who’s been around seniors knows a lot of people in nursing homes because they ran out of money they left their assisted living or senior apartment because they had no more money to pay for the services, they had to go to a nursing home and then you begin to think, why doesn’t medicaid just pay for care at a lower cost, say licensed assisted living facility wouldn’t that save money? Well according to the January study the average cost last year of nursing homes on average was $95,000 a year across the country. I know Massachusetts is higher, forgive me, but I’m talking I’m from Michigan what do I know. All right, how much for assisted living, $55,000. In other words, medicaid could save 43% if people could get the custodial care in the assisted living instead of leaving it if medicaid just paid for it. It’s 43% of the long-term care nursing home long-term care budget instead of a half percent. So, what I’m saying is there’s just no reason at all that medicaid estate recovery makes any sense. I mean it keeps people in poverty, all the state and local governments trying to help people out and we’re keeping them down with medicaid estate recovery because keeping our workforce and getting the skills we need to compete in the 21st century and on and on and it’s unfair on and on and on, and Brian, I’ll end my rant and take a breath of air.
Brian: Is there any other program that goes after you for as though the benefit were alone?
Brian: This is the only program I’ve ever seen.
Jim: Yeah, I mean you might say college student loans but they are a loan and besides you get a big fat asset out of a college student loan, you got a degree which presumably you can do something with. Well, but it’s a loan, right from the get-go.
Jim: No other program, Brian, none, not fire, police, not military, you name it not roads. Yeah, so-
Brian: I don’t know why they targeted this program.
Jim: Yeah, well I could guess that it’s, you know you go back to the ancient politics like Ronald Reagan’s welfare queens driving Cadillacs, okay or you go to Newt Gingrich’s guy drinking hard liquor all day not taking care of his health and ends up in the nursing home. Of course Newt never talked to a guy who smoked and drank and got heart disease and paid for by medicare with no estate recovery, but no, but really I would say my best guess is it’s just the American way of a hand up not a handout. But that was for working folks, if you think about the depression, I’m sure you do every day, I do- I’m kidding, yeah those were families who were the dust bowl we remember the grapes of wrath and all that, well they were working families they weren’t people over age 65 who couldn’t get a job, you know because of their age, so even that hand up not a handout just doesn’t really apply. That’s my best guess, that’s it.
Brian: Well maybe this- where is this bill, did it get out of committee?
Jim: No, the funny thing is, once again it’s House Bill 6698 Stop Unfair Medicaid Recoveries Act, only 15 co-sponsors and everybody I talked to hasn’t heard of it. Okay, well I should put that with a grain of salt, sure NAELA you know our national office heard of it but they say we’re not going to spend the time on it. Alzheimer’s foundation said well we shouldn’t commit all the resources to it because it’s not going to go anywhere. It’s not going to go anywhere because nobody knows about it. I mean you know I should get and talk radio with all the truckers have them drive their trucks to Washington.
Brian: Okay, all right, well, thank you Jim and thanks to you too, Tim for an informative discussion.
Jim: Thank you.
Tim: Thanks for having us, Brian.
Brian: I want to thank everybody who joined us, bye.