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Brett Arends’s ROI: Why Medicaid is for the middle class


Attention, middle-class Americans: Thank your lucky stars for Medicaid.

Most middle-class Americans think of it, dismissively, as only as the medical insurance program for the poor. They figure they’ll never need it.

Think again.

It is Medicaid, not Medicare, that will provide us with a nursing home if we are elderly and run out of money. And as new data remind us, that is likely to affect a lot more among us than many realize.

A stunning 80% of Americans over 60 would struggle to pay for a nursing home even if they spent all their savings, according to a new study.

That includes 60% who couldn’t pay the full bill even if they sold their homes as well.

The study was conducted by the National Council on Aging and the LeadingAge LTSS Center @ UMass Boston, and was based on data drawn from the long-running Health and Retirement Survey. 

Government data show that if you make it to 65 the chances are slightly more than 50% that you will end up needing long-term care and support services, meaning either a home health aide or a nursing home. Some 14% will need these for at least five years.

Without Medicaid, many just couldn’t afford it.

It’s something to bear in mind as politicians in Washington fight over the federal debt ceiling, budget deficits, “big gubmint,” and “out of control federal spending.” Everyone seems to want either more taxes on other people or spending cuts that only affect other people. 

When people talk about “senior citizens” being the wealthiest cohort, they are making third grade errors involving averages. About 10% of seniors are in the financial pink, with an average net worth of $1.8 million, and another 10% are OK, with about $800,000 in total wealth, including nearly $500,000 in cash and other assets.

Read: There’s tons of wealth in America, yet tens of millions have nothing

But the remaining 80% are somewhere from marginal to flat broke. One fifth of seniors have nothing to their names.  

Meanwhile, a private room in a nursing home costs about $110,000 a year (yes, on average). The average stay is two years or less, but nearly one person in seven has to stay for five years or more.

The issue of long-term care is only going to get worse. The industry is struggling financially — even allowing for the usual self-interested pleading. So prices are going to have to go up — probably a lot if we want care to actually improve. Robots can’t come soon enough. Meanwhile, thank your lucky stars—or LBJ, I guess — for Medicaid.

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