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Heavy financial pressures on the federal and state governments are being felt in the Medicare and Medicaid programs. Both of these programs are important safety nets for the millions of seniors and disabled persons in our country. However, as the costs of medical and long-term care continue to escalate, the financial impact of these programs on federal and state budgets is dramatic.

The federal government is increasing pressure on private insurers that sell Medicare Advantage plans by freezing payment rates to these insurers in 2011 and reducing them starting in 2012. Meanwhile, medical costs are increasing by at least 6% per year, and these private insurers are being warned not to increase premiums or co-pays to seniors. Inevitably, something has to give, and it’s likely to be a reduction in the scope and quality of services.

On the Medicaid front, many states are facing larger-than-expected budget deficits because assumed federal assistance for Medicaid is apparently not going to be awarded by Congress. New York may be forced to do without $1.1 billion in federal funds that had been penciled into the state budget.

Due to federal mandates regarding health care, the funding shortfalls will result in a reduction of other services, including education, the arts, and even police and fire. Layoffs of government workers are expected. Medicaid is likely to feel the pinch, as well.

As Elder Law attorneys, we are starting to see a change in attitude at some of the Medicaid offices in local counties, even though the governing laws and rules have not changed. Rather than being compassionate and helpful, many Medicaid workers, compelled by budgetary pressures, are looking for ways to delay or deny applications for medical assistance or to reduce the scope of services. Medicaid is also becoming more aggressive about enforcing spousal obligations of support, pursuing liens against real property, and seeking recovery from the estates of Medicaid recipients.

In these times, we believe that it is all the more important for seniors, the disabled, and their families to be aware of their rights to government benefits for medical and long-term care, which can be ruinous if paid from your own funds. For many, a consultation with an Elder Law attorney will be the best couple of hours you’ve spent in a long time.

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