File Name: 0606172213_March_18_2017.mp3 File Length: 00:55 [START OF TRANSCRIPT] 00:01 John: Welcome to all my Facebook Live viewers. I hope you enjoy the program today. We’re going to be talking about some Donald Trump stuff and some budget proposals, and we’re going to make some rank speculations out there. That’s what we do. When we don’t know what the government’s going to do, we try to guess in that way, you’ll be prepared. Time to go. Just got to get pass that opening. I hope you enjoy the program. Let’s see what we can do here. All right. Here we go. Welcome to Aging Insight, everybody. This is your host, John Ross here live in the studio. I am all by myself today. Lisa Shoalmire is going to be out of the studio for today’s program, but that’s all right, you got me. Of course, I am here and available to take your questions if you have any. Phone number is 903-793-1071. You can call in and ask questions about today’s topic or any topic that we have out there. As we have now been doing for the last three, today would be the fourth show that we've done this, we are also broadcasting this show on Facebook Live. If you're out there and you’ve got a Facebook account, be sure to go and check out both the Aging Insight Facebook, which is @AgingInsight. 02:07 John: Also be sure to check out the Ross & Shoalmire Facebook page. It’s the Ross & Shoalmire Facebook page where we actually broadcast this live. You can go on to Facebook, check out Ross & Shoalmire. By the way, it’s S-H-O-A-L-M-I-R-E. I couldn’t even spell Shoalmire for the first six months that I knew Lisa, so I can understand that little problem. Go on to Facebook, check us out. If you want to see what live radio looks like, you can check it out right there on Facebook Live. That’s where we’ll be. Now, of course you're listening to this program. If you're out there, you're listening because you probably have figured out that we've got some pretty good information out there, that if folks want to avoid going to Nursing homes, if they want to avoid becoming a burden on their friends and family, and they want to avoid becoming destitute, essentially losing their life savings, we know that you can accomplish these goals. It is possible. But there is such a crazy mix of laws and regulations and situations that you have to contend with to deal with all of these sorts of things. That the only way you're going to be able to accomplish those goals is with knowledge. That’s why we show up every Saturday. I had one of my clients come in yesterday, on Friday, and he said, “Well, at least it’s Friday, John.” I said, “Yeah, it’s Friday. Only two more working days until Monday.” Because that’s kind of the nature of our business, it doesn’t really stop. I was up to the office early this morning docking out some stuff for some clients and getting ready to come in here and do this radio show, because I know this information is important and I want you to get it. 04:01 John: Now, I'm not the only one that knows that this information is important. We've got other folks out there in the community that also know that this information is important, and so, I’d like to be sure and thank them for making sure that we can stay on the air. So, special thanks to Edgewood Manor, the Barnett Agency, Dierksen Memorial Hospice, Riverview Behavioral Health, Cowhorn Creek Estates, Curt Green & Company, St. Michael's Hospital, the Retreat at Kenwood, Red River Federal Credit Union, Twin City Rehab and Inspirations, which is a new Nursing Home out there in the New Boston area. As a matter of fact, we do little community brunches where people can come and listen to me or Lisa or one of our other attorneys like Kline Pillow or Kristen Ishihara. We go out on all across East Texas and Southwest Arkansas. We do about twenty of these programs where we get out into the community and give presentations on different topics. We did one on Thursday, I believe, out in New Boston that was sponsored by Inspirations, one of our radio sponsors. I had a good program there. I had lots of folks and attendants and got to build their knowledge level up a little bit. That’s what the program is all about. That’s why we’re on the air, is because of that sort of stuff. So, today’s topic, unless you’ve just had all of your media sources turned off over the last few days or weeks, you have probably seen something about a new budget proposal that has come out from the administration. President Trump has issued a budget proposal, which I have to say, it is a little vague. 06:01 John: It is not entirely clear what Trump’s budget proposal is going to do or what it’s not going to do in specific. But what we do know is that we’re talking about some major spending cuts to a number of Federal programs including shutting some down altogether. That’s on one side of it. Then the other side of it is increased spending for things like Homeland Security and the military. Now, when it comes to people who are approaching retirement, in retirement, dealing with health crisis through their aging process, whether or not the military’s budget is not going to have at least a direct impact on you, you might have personal opinions about it one way or the other. I certainly do. That ultimately is not going to be the focus today. The focus is more on some of these proposed changes, some of the proposed budget cuts and what that could mean to you out there in the community. I have to say, some of these is going to be some speculation. As with all laws out there, we don’t necessarily know what is actually going to be the deal until it finally passes. If you were listening to the news right before we started this program, there was already some talk that many of the provisions in Trump’s budget proposal are already being tweaked around. But, I think we can be relatively certain that there’s going to be some major cuts out there. What you need to know out there is, would any of those cuts affect you? That’s a good question. 08:01 John: Let’s just jump into it and we’re going to talk about some of these. Of course, I certainly welcome all of your questions or comments as we go through today. There are lots of different issues out here and if you’ve got an opinion about it or you’ve got a question about it or a little more explanation. Because I'm here by myself and I have to run my mouth for a solid hour without Lisa Shoalmire to talk to, I’d certainly welcome any distractions. Feel free to give me a call, 903-793-1071. All right. All that being said, we've got this Trump budget proposal and one of the first things in all of these is the elimination of two big block grant programs. Now, what block grant programs are is where the Federal Government gives a big chunk of money to the state or to a particular agency and says, “Here’s a big chunk of money. We want you to use this money to accomplish certain things, but how you do that and how you spend the money is kind of up to you state, you just have to use the money in an effort to accomplish this particular goal.” What we’re talking about is the elimination of two. One of them is the Community Development Block Grant and the other is the Community Services Block Grant. Essentially, what these two programs do is they provide a number of different programs at the state level. For example, the Community Services Block Grant. This money that is given to states is then used in Community Service programs. One of the biggest ones that relates to seniors is the Meals on Wheels program. Meals on Wheels is almost entirely funded through the Community Development Block Grant system. 10:04 John: In this case, we’re not talking about reducing the amount that’s paid for these programs. We’re talking about cutting it, slicing it altogether. By slicing it altogether, we would essentially remove the Meals on Wheels program. Now, I have to say, depending on where a person lives in their later years and depending on their family structure, sometimes the Meals on Wheels program is an enjoyed convenience. It allows somebody to get some food at the house without having to get out and they appreciate it but the loss of it would not necessarily be devastating. I’ll give you an example. I had a husband and wife here in town, here in Texarkana. The husband was quite ill. He was basically homebound, he moves very, very slowly. He had a walker. Just really could barely get around in the home, let alone get out of the home. The wife was really not much better. She was just about in the same boat. Neither of them have the ability to operate a motor vehicle in any way shape or form, certainly not safely. They do still have a car but the wife was quick to admit that the husband certainly couldn’t. She just really didn’t feel comfortable doing it. They are basically homebound. Now, these are also what in our practice a lot of times what we refer to as senior orphans. We use that term to describe people that have… because of whatever the family dynamics are, they basically have no family support structure around them. 12:07 John: In this case, this couple had one child but that one child had predeceased them without any children, so they had no descendants. They also have at least nothing close in the way of brothers and sisters or nieces or nephews, so they're basically alone. They used to go to church and stuff, but now that they're homebound, they can't really do that, so they don’t have much of a community support structure around them either. In talking with the wife, she could walk on her own, the roughly one mile to the nearest Walmart from her home. So, about once every two weeks to a month, she would make the trek to the Walmart and back to buy some supplies some groceries. But other than that, she basically was relying on Meals on Wheels. Most of their nutrition was through the Meals on Wheels program. There is a category of people out there that would significantly hampered by the removal of the Meals on Wheels program, folks like this couple. Frankly, if they don’t have Meals on Wheels, I'm not entirely sure what they're going to do. If you’ve got some personal resources, if you’ve got some money basically, then you can do things for example a call cabs and things like that. In the larger markets, in a Dallas or a San Antonio or an Austin or a Houston, where you’ve got programs like Uber or Lyft, the internet based travel cab company essentially, private contractor drivers that can come out. 14:09 John: I've used that a lot as I'm vacationing in other cities. I found that Uber and Lyft to be quite convenient. You get off the plane, you pull out your cellphone, you hit the button for an Uber driver and by the time you out of the airport, there is your guy waiting for you. I found it to be relatively inexpensive. Services like that are great if you live in Dallas. If you live in De Queen, that’s not going to do you any good. In fact, neither is cab service. A lot of our smaller communities, particularly in our rural area out here, they don’t have access to other transportation services. If they also don’t have that family structure around them or the community structure around them, what this is ultimately going to do is this is going to shift the burden down to community organizations like churches, like other non-profit organizations to pick up the slack. I could certainly see a case where if we lose the Meals on Wheels program altogether, that many of these organizations that offer things like Soup Kitchens and stuff like that, may have to then take the next step and go out there and start creating some actual meal delivery services. Otherwise, frankly I'm not sure what’s going to happen. Probably, the bigger issue on all of these though is, again, let’s take this married couple. They're at home, they're basically able to age in their home environment because of programs like Meals on Wheels that keep them fit. Otherwise, the wife can take care of the husband in her limited capacity. So, they're otherwise basically self-sufficient. 16:01 John: But if they lose their access to food, and they can't come up with another option, essentially what we’re going to be looking at is them having to leave the home environment and go into something like an assisted living or a Nursing Home care. Of course, because of the cost of assisted living or a Nursing Home care, this couple in particular I can tell you would end up qualifying for something like Medicaid. If you're talking about an assisted living that’s going to cause say $3,000 per person or a Nursing Home care which could cost $5,000 per person, right now, the State is not having to pay for these folks because they're paying a little bit for food delivery. You remove the food delivery and what these folks end up being is on a much more expensive government program like Medicaid. Personally speaking, I'm a pretty big supporter of leaning out the budgets. I get that. What I don’t want is to unintentionally increase the budget because we haven’t necessarily thought through the consequences. I think this one has some of those potentials. In any case, I'm going to take a quick break and when I come back, we’re going to keep talking about this, so stick around. I’ll be right back. All right. Thanks for joining me on Facebook Live. I hope you're enjoying the program so far. I'm getting my little commercial break here for about three and a half minutes. I know among other things, I'm also the President of the Board of Directors for the Alzheimer's Alliance and our Day Respite Center which is called Our Place. 18:02 John: It’s a place where people can drop off their family member who has Alzheimer’s and the caregiver can get a little break and the person with Alzheimer’s can get some entertainment, some socialization, have some fun. Right now, all of the meals that we serve at the Alzheimer’s Alliance are actually provided through the Meals on Wheels program. I've got some personal feelings about that. I hate to see the burden of the food shift back to the Alzheimer’s Alliance. As with any non-profit organization, the Alzheimer’s Alliance has a pretty tight budget. We do well. We do a lot of fundraising, but we use those funds very wisely and we try to make sure that we match everything out and our budget is pretty much set. Our budget for example does not include providing meals three times a week for people. That could have an impact on our budget and there are many other non-profit organizations where there could be a significant effect on the budget as well. Anyway, I don't know. I know that it would have an effect. I know it would cut some budgeting but I'm not real sure whether I like it or not. Running your mouth makes you thirsty. It dries up the mouth, plus I got to have my coffee to keep firing up in all of these. If you're enjoying the show out there, be sure to give us some thumbs up or click the little like button over there, and if you got any comments on the Facebook program, whether you're watching live or whether you're watching one of the rebroadcasting programs, if you have a question or a comment, feel free to click the little comment box and type in whatever you like to hear, whether we do it live or whether we’re doing it some other time, we will respond to those comments. 20:08 John: Five seconds and we’re going back live. Welcome back to Aging Insight, everybody. This is your host John Ross here live in the studio on Aging Insight for a second segment of our program. Today’s topic is President Trump’s budget proposals and what they might do, what they're expected to do. What I also like to consider is the unintended consequences. In economics, they referred to the unintended consequences as the cobra effect. I think I've talked about this on the radio before. The cobra effect goes back to Thailand. Thailand had a big problem with cobras. The government got the bright idea to pay people for every dead cobra that they brought in. The idea being that people would go out actively hunt cobras, which would then reduce the cobra population and that would be a great public service. What ended up happening though is because they were paying people to bring in dead cobras, some entrepreneurial-type folks actually started breeding cobras for the sole purpose of having dead cobras. Once they started doing this, the cobra population actually increased. I've got a caller, let’s see if I can get them on the line. Caller, you're on Aging Insight. What can I do for you? 23:06 John: Sure. I actually agree with some of these. Basically your point is, there are circumstances out there where there are people that could be affected. But are we really operating these programs the way we should be? I think about companies like Blue Apron that do at-your­-door-delivery of meals ready to be prepared and they're relatively easy to cook. It seems to be like that would be a whole lot cheaper and easier than providing a hot meal delivered by private paid staff. Amazon can do this cheaper. It seems like instead of the government doing it, maybe government providing some resources to private companies who already have this infrastructure. Of course your other comment was, we've got these churches that are doing all of this work for other countries, and maybe they could turn their focus back to the United States. All good comments, so I appreciate all that. All right. I got to take my next break. All right. Because I know on Facebook Live you can't actually hear the callers when they call in, the caller was basically making the point that the Meals on Wheels program, he understands the problem of like the person that I talked about; the married couple and they're homebound and they can't get out, they have no family support structure. He appreciates their circumstance and sees where that could be an issue. We all know that these programs are not run well. 25:00 John: Because of that, you're going to end up having people who are using things like Meals on Wheels that don’t need it, that are using it strictly as a convenience, that’s certainly a possibility. The other thing, and this is something that I've certainly thought about, which is meal preparation in the modern day is very, very simple. There’s a place right here in town that provides pre-package, pre-cooked meals and a different menu every day, and basically, you can pick them up, you throw them in the microwave, you heat them up, and you’ve got a nice little gourmet meal. You already have companies that are doing a much more efficient job. It seems to me that you can actually have a much more efficiently run program, where instead of having a private paid person delivering a pre-cooked hot meal to a family, it seems to be, wouldn’t it be easier to, at the first of the week, deliver a stack of pre-cooked meals that could then be reheated at their convenience, maybe some small preparation on their own. Just things like that that seems like it could be quite a bit easier to do. Maybe these programs would be run just a little bit better and we wouldn’t have to be worrying about these big cuts. Unfortunately, I don't think that’s not what we’re talking about in this program. We’re just talking about cutting it. I'm afraid that by just cutting it, you're possibly going to run into a situation where you're actually causing the expenses to go up. You send people who are otherwise, getting these programs that was able to keep them at home, and because you lose the program, they end up in something like a Nursing Home on the State Medicaid program, essentially doubling, tripling or quadrupling the out-of-pocket State cost for that same individual. 27:12 John: The one thing we know for sure is that it is definitely cheaper to keep somebody at home than it is to pay for them at a Nursing Home, as a general rule. If you take away some of these programs, that certainly could be an issue there. I appreciate you all checking this out Live on Facebook. We’ve got about another minute worth of stuff on here, then we’ll be back live. About another minute here. I try to keep my mouth running this whole time. I'm trying to pay attention to you, watching this computer right here, watching this computer right here and watching this computer right here. Trying to see what all is going on here. Meanwhile, I've got to run this massive board with all these little buttons and controllers on it and can get a little overwhelming. All right. It’s like we’re going back live in about 30 seconds. 29:12 John: Playing on one of the computers here. All right. Here we go. Two seconds left. All right. Welcome back to Aging Insight, everybody. I appreciate you all listening out there. I appreciate the caller calling in. I kind of agree with some of the stuff he was saying as far as, it seems like these programs’ technology and the delivery of goods and services has certainly changed. Amazon, for example, will deliver food. There are companies like Blue Apron. We even have a local company that delivers or that has prepared meals and stuff, so there are a lot of different options that are available. Looks like I've got another caller on the line. Let’s see if I can get them on here. Caller, you're on Aging Insight. What can I do for you? Yeah, I completely agree. I think that’s exactly right. I would be curious, for example, if you take some of these food delivery programs that are out there and instead of having the government try to do it, which I think everybody realizes that anytime… not everybody, some people blind themselves. 31:12 John: Generally speaking, every time the government tries to do something, they do it poorly. They do it slow. They do it expensive. If you created some say tax incentives, some tax deductions or things like that, if you’re a delivery company that’s providing gourmet meals and things like that out there, if there was an option for taking tax deductions for delivery to certain need-based individuals or things like that where the business was incentivized, you could really have a private option for accomplishing the same thing. I guarantee these companies are going to do it more efficiently. Yeah, that’s right. I think you routinely see that these programs are abused and that’s why it’s entirely too easy to manipulate these programs. The people who are motivated enough to manipulate the programs have learned the ins and outs of them. There are a lot of people out there that abused the system. Again, I agree with you. That’s a product of the government being poor at managing what otherwise looks a whole lot like a business. When the government starts getting into business, they usually don’t do a very good job of it. Right, and their own accounts. Certainly, they don’t have stockholders that can fire the Chief Executive when they're not making decent profit, things like that. 33:09 John: All right. Listen, I appreciate you calling in again. All right. We got a couple of other things. We know the Meals on Wheels is probably going to get cut. There are a couple of others that I thought I might mention, for example, one of the other programs that they're talking about eliminating is the Health and Human Services Office of Community Services. This is a program that they're talking about not decreasing the funding, but just completely wiping out. The Health and Human Services Community Services program, this is the one that provides energy assistance for low-income families particularly a lot of seniors. You always the see stories in the summer of people in Chicago, and it always seem to be Chicago. I don't know why that is. You'll see these stories of people in Chicago who have no air conditioning. In the heat of a Chicago summer, they end up basically dying in their house from heat exposure. You'll also see the stories in some other colder climates during the winter of people who, for example, cannot afford their heating bill, and because they can't afford their heating bill, their heat gets turned off, the gaskets turned off, and they end up dying from exposure. The Health and Human Services program for Community Services, this is the one that can step in and pay for a senior or low-income families’ utilities either on a one-time basis. I think some of them will provide maybe up to two or three months worth of assistance. 35:01 John: These are not programs particularly that are… where you see ongoing deal. This is not something that you sign up for and then the State pays for your electric bill forever. It’s try to help get over a hump, get over a gap. But they're talking about cutting that. Let’s see… It also talks about a lot of other cuts to the Health and Human Services Department. Health and Human Services is the one that runs the Medicaid program. For example in Texas, you have a Texas Department of Health and Human Services. On the Arkansas side, you have the Arkansas Department of Human Services. For whatever reason, Arkansas dropped the “health” out of their name, but it’s still the same entity. These are also the programs that run the law that’s called the Older Americans Act. The Older Americans Act has actually a number of different programs within it like caregiver support, respite care, elder abuse prevention, senior nutrition, Meals on Wheels. There are actually a number of different programs in that. I think they're all going to see some significant budget cuts. They're obviously not talking about removing Health and Human Services altogether, just removing several of their programs altogether and then overall cutting their budget. But as I've looked into this and as I've read a little bit, most of what I have seen is it’s not terribly specific on exactly how they're going to do it. Let’s see. A couple of others, they're talking about cutting roughly $6.2 billion from the Housing and Urban Development, that’s HUD. 37:00 John: HUD does have something called the Section 202 program. This Section 202 program of HUD is what creates or helps funds senior low-income housing development. For example, there’s a place out in the Liberty area, it’s a low-income senior housing area. There’s one in New Boston that I know of. Essentially, these structures, these various houses or duplexes that have been built out there for low-income seniors, these programs have been funded. Those construction programs have been funded by the Section 202 program within HUD. It’s not going to get cut, but they are going to cut $6.2 billion from their budget. That’s about 13%. Obviously, that’s a bunch of money, who knows how that will ultimately affect everything. One of the others that they're talking about cutting completely is something called the Senior Community Services Employment Program. Let’s say that you have the ability to work. You're over 65, you're retired, but you still have the ability to work. The Community Services Employment Program is where basically the government pays you as the senior to work in the public sector. For example, I know many of the local charities that have volunteers that run their programs, many of these also will have a retiree, a senior who looks like a volunteer. They're doing all the same things as the volunteer but they are actually being paid through this Community Services Employment Program. 39:04 John: Generally speaking, this is something that maybe somebody who is retired at 65, they're still able to do some work, maybe not at the level that they used to but they are still able to do some work. But they're also struggling on a very low-income from security. They need some extra money. I think most seniors will admit that it’s relatively difficult to find some work out there. There are certainly some biases. There are lots of employers that are happy to hire seniors. You'll see a lot of the retail outlets like Walmart and things like that. Basically, what this program does is it helps provide some income to that individual but then it requires them to work in public sector service jobs like working at non-profits, and that can be a pretty good benefit for some of these non-profits where they rely on volunteers. Sometimes volunteers can be tough to get out there. I'm on the Board of Directors for the Alzheimer’s Alliance and we run our Day Respite Center, and one of the things that we take pride in is that for every person with Alzheimer’s that comes to our Respite Center, we try to have at least one volunteer. We have a one-to-one ratio. If you’ve got 10, 11, 12, 13 people that show up for one of our Day Respite Centers, that means that we got to have 10, 11, 12 volunteers on that day. Finding people that have the heart, the motivation and the energy, frankly, to come and spend a full eight-hour day singing and dancing and having fun and helping with the friends at the Alzheimer’s Alliance, that can be tough getting those folks around. 41:02 John: Anyway, those are some of the big ones with the budget thing. There is one other big one that’s coming out as well. This is the American Health Care Act. This is one that intends to make some changes specifically to the Medicaid program. There are two out there that I want you to know about. I've got to take one more break and after I take this break, then we’re going to talk about the changes to Medicaid and what that means to you. Frankly, I think these are some of the bigger ones. Stick around, we’ll be right back. All right. Rolling up on our last segment now on Aging Insight. Hopefully, you're getting some good information out there. I hope you enjoy it. This program is not an editorial. I'm not here to tell you what my opinions are. You don’t care what my opinions are, or maybe you do. I don't know. I do actually have some relatively strong opinions about some other stuff. But I try at least to basically just tell you here’s what I think they're going to do. Whether you agree with that, don’t agree with it, don’t care really one way or the other. There are some people that for example fully supported, some people that completely hate it. I don't care what your opinion is, I don't care what my opinion is. You don’t care what mine is. None of that really matters. But I think we do need to know what these programs are likely to do so that we can be informed out there as we make decisions. If you're somebody who’s on Meals on Wheels and it’s probably going to go away, you need to be planning right now to figure out what your alternative is going to be. 43:08 John: Looks like I'm going to go back live in about ten seconds. Short break. All right. Here we go. Welcome back to Aging Insight, everybody. This is the last segment of the day, so if you’ve got any other questions, feel free to give me a shout, 903-793-1071. You can also check us out live on Facebook on the Ross & Shoalmire Facebook page. All right. Before the break, I was going to talk about two other things. One of the other proposed laws out there, something called the American Health Care Act, which is potentially going to make some significant changes to the Affordable Care Act and things like that. Most of which, and I've talked about this on the show before, the Affordable Care Act generally has no effect on seniors. It’s for the working uninsured. That was its whole point, was people under 65 who are not eligible for Medicare but could not get health insurance some other place. That was the whole point of the Affordable Care Act, whether it did a good job or not is open to debate. I certainly have some opinions about the fact that I pay a gigantic premium for what effectively rolls out to be no insurance. I certainly have some opinions about the Affordable Care Act but for purposes of our program today, we’re talking about what are the effects on seniors. The Affordable Care Act doesn’t really apply to them and neither them does the American Health Care Act, except in a couple of places where it might change the Medicaid program. 45:04 John: There are two ways that it could change the Medicaid program, and I thought I would talk about both of those. One of them, you’ve got to understand a little bit about Medicaid. Let’s say that based on your income and assets, you are qualified for Medicaid. You’ve never applied for Medicaid, you’ve never needed Medicaid because you're sitting at home and you're all perfectly healthy and happy and all of that is fine. Then at some point in time, that changes and you find yourself in a Nursing Home. The actual application for Medicaid can be daunting trying to gather up all of the information. When we’re planning for our clients and when we’re doing Medicaid applications for them, one of the things that we anticipate that we’re going to have up to 100 to 150 man-hours in the preparation and prosecution of that Medicaid application, and that’s even for simple ones. They are daunting. The other thing you can run into is you may not have access to all of the information you need. What we run into on a pretty regular basis is maybe a client or maybe the Nursing Home resident has a life insurance policy. We know Medicaid is going to want information about that policy. Does it have a cash value? Things like that. What we have also found is that the insurance companies are often very hesitant to provide that information for whatever reason, or the family don’t know exactly who the insurances with and it can take some time to gather that. Let’s say you go into the Nursing Home today which is March 18th, but you're not able to gather up all of the information until the middle of May, so two months later. 47:03 John: Two months later is when you actually file the Medicaid application. Meanwhile, you’ve been in the Nursing Home this whole time. Again, let’s assume that you are qualified this whole time. The current Medicaid rule says that Medicaid will pay not just from the day you applied for Medicaid but also up to three months prior to the day you applied. The whole point of this is to essentially give that family who has had the crisis of getting somebody into the Nursing Home, but it’s taken a long time to get the application done. This gives them the ability to take a little time knowing that Medicaid will reimburse the facility back three months. All right. I've got another caller. Let’s see if we can get them on the line. Caller, you're on Aging Insight, what can I do for you? Hello? All right, well maybe not. If that caller is out there and they're still listening, maybe they can give me a call back. I don't know if that was you or if that was my computer, who knows? Anyway, Section 114 B of the American Health Care Act would repeal the retroactive coverage of the Medicaid. This would basically take away that three-month prior rule. What this means to you is if you may end up in a Nursing Home at some point and you may qualify for Medicaid if you went into a Nursing Home, it is imperative that you have your stuff together. Keeping a file, for example, of paystubs… Right before the first of the year, you get that letter from Social Security that says, “Here’s how much we’re going to pay you for next year, here’s the gross amount, here’s how much it’s going to be deducted for Medicare, and here’s the net amount.” 49:10 John: You get that the first part of the year or right before the first of the year. Save that thing, it’s going to be needed. If you get a pension from TRS, I have people every day that get a retirement check and I’ll ask them, “How much do you get?” They say, “$2,000.” I’ll say, “Is that how much is deposited?” They’ll say, “Yes.” I’ll say, “What’s the gross amount before they deduct your insurance or taxes?” And they don’t know. Know that. Have some proof of it. Know what your income is, gross and net and be able to prove these things. Keep copies of your bank statements. Keep copies of your insurance policies. When you get that little letter from the insurance company that say, “Here’s how much your policy is worth, here’s the cash value,” keep that stuff. Just find you a file and get organized. Particularly in light of, if you might be in a Nursing Home and you might be on Medicaid, because if they remove the three-month retroactive coverage, there could be people who are unable to pay for their care, but because they can't gather up all the information in time, have a private pay period that they can afford. There are only limited reasons why Nursing Home can kick somebody out, but failure to pay the bill is one of them. That’s a potentially big deal there. The other big change to the Medicaid relates to the home equity rules. If you live in Texas or Arkansas, for example, and you need to go to the Nursing Home and you want to qualify for Medicaid, you can have a home including all the land the home sits on, as long as the total value is less than $552,000. That’s the home equity cap. 51:00 John: Some states have adjusted that upwards. I think we can all imagine that a home in Fouke, Arkansas versus a home in Manhattan, New York, are going to have different valuations. If you have a 3,000 square foot home in Fouke, Arkansas, the value of that home is going to be significantly different than a 3,000 square foot home in Manhattan. Because of that, some states have been able to adjust that home equity cap. For example, in Texas, you can exclude a $552,000 home, in New York, you can actually exclude an $840,000 home. One of the things that the American Health Care Act is talking about repealing is that home equity cap. That would mean that everybody is stuck at the $552,000 range. Now, that, at least from my listening area, is not going to be an issue. A $550,000 house in Texarkana is a big old house. But it could have an effect on the people that have large farms, because again, notice I said the house and all the land the house sits on. If your house is sitting on 300 acres that’s valued at $1500 an acre, you may be rolling up on that $500,000 range. Because of that, the State’s inability to increase that could have a bigger issue. More importantly, right now, Medicaid exempts the value of the home, as long as the person intends to return home. Even if you stay in a Nursing Home for ten years and Medicaid is paying the whole ten years, the house is excluded the whole time. But one of the things that some of these changes would do is they would actually change it to where the State could say, “Look, you're not getting any better. 53:07 John: Even though you intend to go home, you're never really going to. Because you're never really going to, we’re going to now get to count your house against you, force you to sell it and give us the money. That is a much more dangerous thing. This requires a lot more pre-planning on the individuals. It makes putting the house in a trust, for example, much more important. Anyway, I've reached the end of another program. I hope you all enjoyed it. Thanks to all of our sponsors. Thanks to you out there who are listening. I appreciate it. Lisa and I should be back here next week. Thanks. Bye-bye. All right. Thanks to everybody that was watching on Facebook Live. I appreciate it. I like knowing that you're out there. Again, even if you're watching this as a recording, feel free to comment, share, ask questions. We’ll be happy to answer them at any time. Thanks. [END OF TRANSCRIPT]