Boomers & Medicaid Expansion

ObamacareNow that the Affordable Care Act has been cleared constitutionally by the Supreme Court, it’s up to States individually to decide if they wish to use the monies set aside for expansion of their existing Medicaid programs, or some variation thereof (like subsidizing purchase of regular insurance), to cover low-income individuals who otherwise could not afford health coverage.  Currently, many State programs cover only children & folks on disability.

A number of States have accepted the money; a few States, my own included (Florida), have refused it.  To learn why, I wrote my legislators asking their reasons for turning away those dollars, in our case $51B over 10 years to cover the approximately 1.2M uninsured here; what follows are the reasons, similar to those heard around the nation by others who have refused to participate:

  • By refusing the money, it will go back into the general US treasury and help reduce the deficit (folks for the expansion claim the monies, taken from FL taxpayer dollars, will just be used by other States);
  • We don’t trust the Feds to live up to this stated commitment, so we’re afraid we’ll be on the hook for the expansion when they renege down the line;
  • Our current Medicaid system is terribly dysfunctional, so we don’t want to be forced to expand it.

Hmmmmm…..

Something just didn’t seem right to me, so I fact checked their reasoning; here’s what I discovered:

  • The way the law is written, the monies for it are in a separate fund (not the general treasury), coming from a combination of new taxes on wealthier Americans, fines from companies/individuals who don’t Obamacare factsadhere to it, and projected savings from folks no longer using uncompensated emergency room care, instead using the regular system (less costly) thus improving their health outcomes (also reducing costs); monies refused by States go back into this fund to be used for future health care, not into the general treasury to reduce the deficit nor to other States currently willing to accept these dollars;
  • Although the feds are notorious for their “unfunded mandates” (eg passing a law without dollars behind it for enforcement), the federal government has never stopped paying on its medical obligations (Medicare/Medicaid), nor anything for which funding has been allocated;
  • Many State Medicaid systems are in fact quite poorly run (and so underfunded that no decent doctors will participate) which is why alternatives like subsidizing the purchase of regular insurance is an option that can be permitted (the option forwarded by a FL legislator who believes in using the federal dollars – he’s Republican btw); no State is being compelled to simply expand their current faulty Medicaid system.

Knowing the facts is particularly germane to we Boomers, because many of us are without health insurance, not on disability, and quickly falling into (or already in) the category of adults who qualify for this expansion of State health benefits.  About 8.6 million of us in fact, who were found to be without health insurance according to a special 2009 report by Commonwealth Fund.  As a result of the Great Recession coupled with ever increasing health care costs, Boomers caught between drastically shrinking retirement accounts and high Boomer unemployment (with the lowest rate of re-employment) are the biggest casualties.

So, Boomers – a generation known for its high rates of diabetes, heart disease, and obesity – living in States refusing expansion of more affordable care to a larger number of their citizens, are the group to be hardest hit by such decisions.  Next are our many adult children who are unable to find work offering benefits, in a system that relies solely on such employer-based access for the most affordable coverage.

As you determine your position on this issue, may the facts be with you.

Life After Death, Boomer-style

Ruth D Benincasa

Mom in better times

My mother just died.

She was 92, in quickly deteriorating health, and didn’t see the inside of her home again during the final six months of her life – she needed far too much, and round-the-clock, skilled care – best handled in a Skilled Nursing Facility (aka, “nursing home”).  We found her the best available facilities in this woods’ neck, stayed on top of her care daily to ensure it was highest quality (aka “squeaky wheel”), visited her daily, and, I hope, helped her to leave this world with as little suffering as her body would allow.

I’m sad.  Sad that her body was so broken in the end; sad that given my own disability I couldn’t do more for her myself; sad that there will be no more visits and dinner outings with her; sad that I’m now an orphan (daddy died in 2009).

John H Benincasa Sr

Daddy in his final year

In that I’m a wee too old to be upset that I have no parents now, I’m realizing that this is a Boomer phenomena – we take the loss of our parents harder than our parents did the loss of theirs.

Why is that?

Here’s my theory.

I believe our parents were, well, a bit more adult adults than we are as we live our dream of perpetual youth.  We’ve depended on our parents far more than they did theirs, remaining “children” far longer.  Too many of us depend upon our inheritance as our retirement plan, having spent up and borrowed away what we earned.  Even those of us who became, and will become, our parents’ caretakers in the end as was I, and therefore took on a type of “parenting” role with and of them, do so in a way different than our parents did theirs; some of us doing it from afar and therefore, frankly, less effectively by necessity, some petulantly (annoyed that an ailing elder is interrupting their daily routine), most of us lovingly but perhaps with a tinge of shock that we must sacrifice in ways to which we’re unaccustomed.

Their “greatest generation” moniker came from lives of sacrifice, stoic determination, toughened by the need to take on great responsibility at an early age (some right after high school, many before even completing it) thus being better prepared for such significant loss.

Our at times aptly coined “me” generation came from being more coddled, cared for through college and for some beyond, we had/have lives of greater comfort than they; we are softer.

They felt like grown-ups who understood the loss of their parents as another part of life to rise above.  We feel like….orphans.

My mother and father, I realize now, lived up to their generation’s sensibilities, something I didn’t appreciate enough when they were alive.  I will try to emulate them now.

Mom, Dad, I think I’ve finally learned what you tried to teach us all along – the ideals of humility, thrift, strength to face and conquer adversity with dignity (eg without losing stride…) that your generation tried to teach ours but we cast aside as too “old fashioned” – now that you’re gone, I’ve finally grown up.

How Boomers Will Choose a Retirement Locale: Weather? Taxes? Or One Other Key Factor…

retireesWhen our parents got down to choosing where to live out their years of retirement bliss, they based that decision, generally, on the following criteria:

  • warm climate
  • lower taxes (particularly for those in the Northeast)
  • affordable, senior-friendly communities
  • golf (or other favorite sport like boating)

Not in that order particularly; perhaps even equal in importance.

Then came Boomers’ turn to choose retirement Eden, and I predict – or hope, or both – we will include one key factor; for some of us, it may even trump one or two of the others on our list:

  • political & cultural climate

That portion of our youth, activism and strong political/social views, just might influence where we finally settle down to live out our last 30+ years.  After all, that’s almost 1/3 of our life, so we’re wanting more than early-bird specials and Jai-Alai.

As the country becomes ever more polarized (thanks to us…we started out polarized and remain so in our current dual roles as powerful voting block/generation in charge both legislatively & industrially), we will want to live in a place that shares our views governmentally & socially, from gun rights to health care.  Boomers who lean left politically will choose states like New Mexico and California. Boomers who lean right to far-right will love places like Arizona & Florida run by the Tea Party and the NRA, where their views are embraced by the populace and the leaders they choose.

The importance of these factors as we determine our retirement move is driven by the role cultural & political comfort plays for us (far more than it did for our parents): Culturally we care greatly about such things as quality elder care for our parents and then us, a supportive environment for mid-age & older workers/entrepreneurs as we pursue our “second act,” affordable health-care options (as we live longer and more active lives than our parents did), and 55+ communities’ emphasis on healthy lifestyles; politically we are not comfortable in a place where we would be surrounded & governed by those whose world view is the opposite of ours – and if we can’t move to a state that meets the criteria, we will at minimum find safe haven in a city/county that does.

So, states wanting to woo us, play this socio-political ace in your deck to attract our lucrative generation to your shores.

Boomers, pay close attention to this key ingredient when you make this very important decision.  I can tell you from personal experience; living in a state far removed from your cultural/political sensibilities is very painful indeed.

“Are We Better Off Now?” A Few Answers

I’d like to answer the question posed by the Republican candidate for President: “Are you better off today than you were four years ago?” in a way I keep hoping the Democratic candidate for President would respond but hasn’t; for a “real people/real lives” perspective:

  • Ask the spouses of military personnel brought home from Iraq – they will say “yes”…
  • Ask any GM or Chrysler employee, and the owners/employees of all the businesses fed by these companies – they will say “yes”… Continue reading

A Lesson for Boomer Men from Fred Astaire

Ever watch TCM – you know, the channel with all the wonderful old movies?

I do, and recently tuned in for what I thought would be a delightful movie with Fred Astaire and Leslie Caron called Daddy Longlegs – a charming romantic comedy!

Actually, not really.  In it, Mr. Astaire who at the time was 56 and pretending to be 10 years younger, falls in love with Ms. Caron who at the time was 24 and not pretending at all (OK she pretends to be 16 in the film’s opening, but ends up being about her real age at the end).  Throughout the movie, Mr. Astaire’s character goes on about how inappropriate it is for a middle-aged man to court a woman young enough to be his daughter; the script has him saying just that, in fact.  But, he’s a scillionaire, she’s a poor orphan from France – let the dancing and woo’ing commence!

Ugh! Continue reading