Eliminating the Medical Expense Deduction Would Seriously Harm People Who Are Chronically Ill

Another important announcement from NAELA.  This would have devastated us in caring for my mother-in-law!

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Older man kissing sick wifeThe House Republicans tax proposal introduced today ends the medical expense deduction. This change will cause major harm to individuals and families trying to pay for the catastrophic costs of long-term services and supports (LTSS).

Read the bill text.

Here’s how you can help:

Call your representative – Look up the direct office number in the House of Representatives Directory.

Post this or your own thoughts on social media.

Warn others in your local community organizations.

Read NAELA’s “Overview of the Medical Expense Deduction for the Chronically Ill” and NAELA’s “The Medical Expense Deduction for the Chronically Ill, Key Points.”

LTSS provides assistance with Activities of Daily Living — eating, transferring, bathing, dressing, and continence. In many instances, individuals who need LTSS must be placed in a nursing facility to receive 24-hour care. Conditions that may require LTSS include Alzheimer’s disease, Multiple Sclerosis, or spinal cord injury.

The tax code allows individuals to deduct qualified long-term care expenses if they are chronically ill, meaning those unable to perform two or more Activities of Daily Living without assistance, or who need constant supervision because of a severe cognitive impairment, such as Alzheimer’s disease.

These expenses are usually catastrophic, requiring many Americans to spend all of their income and to liquidate resources to pay for care. For instance, paying for nursing home care can quickly impoverish middle- and working-class Americans, costing a median of $97,000 a year for a private room.

According to NAELA President Hy Darling, CELA, CAP, “The problem is as much a practical issue as it is a policy one. Fundamentally, many individuals paying for these costs will not be able to pay for their care and federal income tax at the same time. Raising the standard deduction and lowering tax rates will not address the issue.”

Why wouldn’t increasing the standard deduction and lowering tax rates help? “Because many chronically ill Americans must pay all of their income towards care, and without the Medical Expense Deduction they could still have a tax liability that they cannot afford to pay,” explains Darling.

Put simply, eliminating the Medical Expense Deduction puts chronically ill Americans between a rock and a hard place. If these individuals cannot pay for the cost of LTSS, this could lead to eviction from their care facility. Yet paying for their care and not the increased tax creates an uncollectible tax liability. And, it likely would lead to an increased reliance on government programs. Many middle- and working-class individuals must “spend down” their resources to qualify for Medicaid. Without a tax subsidy, there is an increased incentive for people in need of care to participate in an already stressed federal/state program rather than assuming personal responsibility for their care or the care of their loved ones.

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I Just Want to Ride…

Motorcycle Arlo Guthrie wrote the Motorcycle Song (The Significance of the Pickle) in 1967 as part of the counter-revolution then sweeping the country. Son of folk musician Woodie Guthrie, Arlo Guthrie’s best known work is Alice’s Restaurant Massacree. The chorus to the Motorcycle Song is as follows:

I don’t want a pickle

Just want to ride on my motorcycle

And I don’t want a tickle

‘Cause I’d rather ride on my motorcycle

And I don’t want to die

I just want to ride on my motorcy – cle.  Continue reading

What to Do When Mom or Dad or Both Move In Redux

(As I mentioned in the previous blog this subject was suggested by a follower, so if you have an issue you want addressed let me know, and if I can address it I will try to do so.)

Herniated disc with pressure on spinal cord

26 years ago I fractured my back at the T7 vertebrae. I was participating in a training exercise and I had a partial parachute malfunction. I actually heard my back break when I hit the runway; it did not help that I was carrying 60 pounds in radios alone. Anyway, I recovered, but I have had back issues since then, and last week I blew out a disc in my back. I was doing something I should not have been: I was getting out of bed. I can only tell you the pain was excruciating; it went on and on for hours, and then around 3 pm it stopped. The negative to this was that I then had nerve impairment, and as a consequence I cannot make my left ankle and the associated muscles work.

I have a number of consults set up, but right now I do not know what will happen with my back and leg.

While I am optimistic, I would give a great deal to “know” that everything will be alright. So it is with most of you as you face the uncertainty of how to care for elderly loved ones. I can only say that the best advice I can give is to prepare now. Old age is coming for us all, and we all need to plan accordingly. Last week I talked about the importance of powers of attorney, and this week I will address advance planning.

Long-term care is incredibly expensive. Right now it costs around $7000 per month to provide the care my mother needs. She has received such care for nearly 18 months; as you can see this amounts to $126,000. My mother-in-law has been in a facility for over 3 1/2 years, amounting to over $315,000!I don’t know about most of you, but I don’t have this amount just lying about. This means you need to plan ahead. One tool for doing so is to invest now in long-term care insurance. I will not mislead you; long-term care insurance is expensive.

The principal advantage to purchasing long-term care insurance is that it will protect family assets in the event long-term care is required. It might be a better idea to think about a whole life policy that allows an individual to use the cash value for long-term care. I am not an expert in this area, but contact me and I can put you in touch with people who can give you more information. Candidly, most people fail to pursue either option, so next week we will talk about Medicaid and other planning options. Until then take care.

 

Family law attorney experiences first-hand significance of elder law

THIS IS AN ARTICLE THAT RAN IN THE GAZETTE YESTERDAY:

Bill Gazetter Main PhotoFor attorney William “Bill” Moller, elder law hits close to home. “When I meet with clients who are trying to make long-term care decisions for themselves or their elderly relatives, I know exactly what they are going through, because I have been there,” he said. Continue reading

Medicaid – Planning Ahead Can Save Assets

ElderCounsel_Logo_MemberI ask many of my clients what will happen if they are diagnosed with a sickness such as dementia or Alzheimer’s, or need twenty-four care some day. Very few of my clients can afford the cost of twenty-four hour care in their home or elsewhere. This type of care ranges from $40,000 to $100,000 per year. None of my clients can afford to lose this much in either income or assets.  Continue reading

A Tale of Two Mothers

Bill Moller

Bill Moller

In the past we have run articles about different legal issues, but right now I want to share some personal stories.

Two years ago, my mother-in-law starting exhibiting some worrisome behaviors. After spending several months in Florida for assessment and tests, my wife finally moved her mother here to Colorado.  Within a month of moving here we had to place her in a memory care unit at only age 72.  My wife’s mother was not cooperative throughout this process, and we were fortunate to get the documents that we needed to be able to take care of her business for her. My wife is her legal representative and takes care of all of her needs. It has been a very difficult journey, and the journey continues.  Continue reading