Next week, my legislation, HB 1141, that requires South Dakota to study and develop a new model to provide affordable nursing home care will be heard in the Health and Human Services Committee. If this is an important issue to you, I encourage you to contact members of the committee. You can get their information on http://www.sdlegislature.gov. Nursing home care should be affordable so residents do not have to resort to Medicaid coverage. Ultimately, more Medicaid funding primarily benefits providers while still leaving residents in the difficult position of losing their life savings to pay for the care they need. We should do better for our seniors, and HB 1141 is a start.

Let’s be frank and honest about our nursing home insurance system in South Dakota. A person seeking to insure against the cost of long term care has two options:

(1) get private long-term care insurance; or

(2) be rich — like, really rich.

The private long-term care insurance market has all but disappeared. In my law practice, I have clients who are in good health but get denied coverage for long-term care insurance. It’s incredibly tough. If you are able to qualify for private long-term care insurance, you likely will not be able to afford it.

If option 1 and 2 above are not available to you, your only other option is to “spend down” your resources in order to qualify for Medicaid. “Spend down” means selling your house, draining your retirement accounts, or cashing in the CDs. Medicaid resource guidelines only allow a person to have approximately $2,000 to their name in order to qualify for coverage. This may not technically be a tax, but government requiring you to spend all your money to get care you need is not far off.

After you “spend down” your assets, you can qualify for Medicaid. Fifty-five percent of South Dakota nursing home residents are on Medicaid, which means taxpayers are paying for it. As the cost of long-term care increases and resources dwindle, this percentage will continue to increase.

Last year, we appropriated more money for Medicaid spending on long-term care. This was absolutely necessary in the short term to keep many rural nursing home facilities open. But we need to do more than just throw money at this problem every couple of years. Nursing home care should be affordable so residents do not have to resort to Medicaid coverage.

Ultimately, more Medicaid funding primarily benefits providers while still leaving residents in the difficult position of losing their life savings to pay for the care they need.

No one should lose their hard earned savings, including our seniors. HB 1141 is necessary to move our state to a fairer long-term care system that recognizes that long-term care should not be free, but it also should not bankrupt a person either.

(1) comment

bjs12258

There is another option. Short Term Recovery Care insurance is available in 32 states - just not South Dakota. These policies can pay benefits for long term care services, they just do it on a limited basis. However, according to Genworth ( who pays more benefits for long term care than any other carriers) 49% of their claims are for less than 1 year. So for many people a one or 2 year plan would be enough. These plans have been filed for approval in South Dakota but rejected for approval every time. They are available to our neighbors in Nebraska and Iowa - seems unfair that the good people in South Dakota are precluded from this valuable coverage.

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