Where things stand today. If you would like to help with this in any way. Look to the bottom of this post for more information.
I spent the hours since my last posting working on the issues found in bumping into a Medicaid debt owed by woman who died on this place back in 2007. I have read most of the laws, quite a few of the common law cases, and talked to a whole lot of people. I even paid a lawyer to make a few phone calls and discuss finding some way forward. What I found was shocking.
Apparently, and you might want to know this some day:
- When people die in hospitals, hospice care, and nursing homes, their insurance is supposed to pay for the expenses.
- Once the insurance hits a cap of some sort the remaining expenses are supposed to be paid from savings of the person under care.
- And once savings are depleted Medicaid steps in and pays the bills. At this point there is a practical limit to the bills Medicaid pays, so once the limit is hit the amount paid goes negative and a debt is accrued from that point forward.
This debt will almost certainly be collected following the death of the beneficiary. So what we have is a situation where a person, knowingly or not, accrues debt for which any remaining value of any thing the beneficiary owns can be used to pay off the debt incurred in the care of whoever went into care and died.
But the person needn't have died right away. They might have survived another ten years and died in a plane crash. Any Medicare debt which went uncollected up to the plane augered into the dirt is debt which can be collected from the estate of the deceased. Because of this simple fact there are no time limits on collections, reasonable or not.
Now any reasonable person might think this is just, and right. People need Medicaid, and in order for Medicaid to continue these outstanding debts ought to be collected if it is possible. SO, this reasonable thing, the way we pay for health care in the United States generally, has some pretty extreme downsides to it which on the surface appear reasonable in the general sense, but in the specific can be very unreasonable. Here's a short hypothetical:
In 2020 a man is found by his neighbor laying on the floor of his kitchen and unresponsive. The neighbor calls 911 and the ambulance takes the man to the closest hospital for care. The man has COVID virus and is given every opportunity to regain consciousness through heroic effort of the Emergency Room, Intensive Care, and everyone else that might offer some sort of aid. The man has a "do not resuscitate" notice pinned to his refrigerator, but the Emergency Medical Technicians didn't see it. The man has family who might have given other instructions, but because of the restrictions inherent in COVID care at the time, they are never given an opportunity to make any decisions. In fact, they only learn of the death through a call from someone trying to figure out how to pay for twenty-three days of keeping a respirator tube down the throat of they guy in ICU bed twenty-seven who never did regain consciousness. He left behind half a million in unpaid medical bills, a house, a car, and his lifetime of stuff. He had savings, a retirement account, and life insurance. His Last Will left everything to his only child.
The child lost his father, sad enough, like so many did in those long dark months. But he also lost the home his parents left to him because it was worth around two-hundred thousand dollars. The savings the child would receive were taken because $200K isn't nearly enough, so another fifty-thousand in cash is gone. As is his mother's jewelry, the retirement account, and the car. In fact, all told the estate of the man could only pay for $450K of the $500K of debt. And by the time the child found out, while settling the estate of the father through probate, interest had accrued which kept every dime of the $550K estate. If there were any remaining debt, and the child not be hopelessly poor, the child would be held to account for any unpaid arrears. Nobody told anyone, anything, which would have changed any of this. These things are not common knowledge and by the time it all came to completion the damage was done.
In the way I have just described the entire family fortune, all of the value that might have passed from one generation to the next, which might have lifted that family to a new social level and insured care, feeding, and education of following generations, is lost.
A million people died of COVID in the first few years, perhaps five times that number were hospitalized and survived. So many families effected, so much cost, most of it uncontrolled by anyone as emergency measures were taken, most of which were completely ineffective. The open question remaining is: how many family fortunes were made due and payable upon demand? How many family fortunes completely knocked out? And why do we pay for health care in this way?
I can't answer this last question, it is beyond my imagination. And since I receive publicly funded health care I really have no skin in the game. But the fact remains that somehow I am now being effected by this unjust, though perfectly reasonable, system.
None of the facts in my hypothetical scenario above apply in our individual case. We had no family members whose legacies would be denied to us. We had nobody wresting control of our loved ones from us at our expense. Except that those individuals who left behind a debt to Medicaid were associated with the dirt our homestead farm was eventually built we have nothing at all to do with this. We are collateral damage. The injustice, in our case, is that Medicaid came after the value in my Farm only after I had bought it and began making improvements. Medicaid never informed me, or anyone else, of the fact that they had some claim against my land; never told me, or anyone else, that there was interest being accrued on the debt levied against my Farm. In fact: were it not for me attempting to finalize the sale of my Farm we would still be ignorant of the debt or the lien. They made no attempt to collect the debt prior to our buying it, never notified anyone at all of anything at all prior to us investing our entire amount of equity in the land we call home. All in the name of keeping the Medicaid fund restocked with the cash vital to doing the good work that they do.
Medicaid has been given extraordinary power in this. There are no limitations as to time allowed to collect the debt. While every other area of Law, except perhaps murder, has some means of saying that the law can no longer be applied because the offending action has lingered too long. Medicaid can sit back and make no efforts at all, then swoop in when a sale of the property be considered and stop the sale and demand payment from any proceeds. The effect of this is that people who would normally enter into probate proceedings to take over Father's or Mother's assets just walk away from their rightful inheritance because they haven't got the three hundred thousand dollars to pay, while the estate isn't worth that amount. In a world of houseless persons, thousand of houses are being left to rot because of this sort of debt.
In our case we bought the land from a woman who did not know anything at all about a Medicaid debt. Through our investment she redeemed her land from tax foreclosure and contracted a sale which relieved her from being homeless. And when she died a few months later she left the valuable Contract behind as her legacy to her own family, not knowing that she would also leave the debt of her own care to them as part of the bargain.
In our case the County Tax Office knew nothing of any lien for repayment of Medicaid debt. They were simply obeying the law by letting the Woman redeem the title to the land and then letting us clear away the sadness we found there before building our home. The County was never told that there was a lien placed upon the title to our homestead land, nor could they notify us of these facts. All the while the interest was growing, the debt increasing. Nobody told anyone of any thing.
So we have come, in just a few short weeks, to a place where we can now say that the legally entered into Land Sales Contract is perhaps a moot point. There are two probate issues that now must be worked through which otherwise were pretty straight forward prior to learning about these debts. The equity in cash, labor, and blood, we put into the Farm and our home may be in serious jeopardy because the means Medicaid uses to collect on these debts. It is all a reasonable injustice.
The best case scenario for us is that we will participate in the probate proceedings to clear up who owes the money, then pay whatever amount is decided for the land we bought seven years ago for a generous amount and for which we have paid all taxes, maintained as our home, and improved steadily since day one. Best case, we pay what we said we would on the Land Sales Contract and that will be the entire amount, but we won't be paying to those who would have had their lives improved by the money, we will pay debts which have nothing what-so-ever with us and our lives.
Since the day we learned of this outstanding and well hidden obligation we will eventually be held to account for. We informed those responsible for the debt and they made contact with DHS to try to work things through. DHS has not called out to us despite our involvement, but I did call them. DHS is continuing to work through the issues they must, but have never made any attempt at contacting us or including our concerns. And since I am the Personal Representative for one of the deceased people involved in this it seems that I ought to be included in all of these things.
Any money that DHS claims as theirs to collect will eventually be paid by us. You'd think they would wish to talk to us first.
If you know us, or even if you don't; if you have been following our story, or even if you merely heard about it and want to help, we want you to get in touch. We don't know what we need, have few resources and fewer remaining ideas as to how to move forward. We think we are defensible by lack any way to know how or do anything about this. So please let us know about you, even if it is only moral support you can offer. There's a contact form just to the left of this page. Please use it.
We need an army.
Most helpful notes:
- I have received ask why our title insurance won't be of some help to us. We have no title insurance because of how we became involved in this property. We had no money for it at the time, but there would have been no lien to find at the time either. The first lien DHS levied did not occur until well after we entered into the Contract for purchase and months after the woman who sold me the land died of cancer. Title insurance, had we done a conventional sale, would have not been issued.
- Other helpful notes usually ask why we weren't informed by the lawyer helping in the purchase. Again, there was no money for lawyers, and there were no levies. We were faced with helping a homeless woman to get off the streets, we had very little money but what we did have went directly into helping her to help us. Any lawyer worth a dime would have just told us to run away. But we could never have run away from a duty to this poor helpless woman as her land was taken from her to pay County property taxes. We worked for six months, six days a week, twelve hours a day, to get the money needed to redeem the land from property tax foreclosure and to get Colette Kramer out of her car and into a house. If I lose everything, getting her off the streets, so that she would not die alone in a car in Winter, is the best thing I ever did and it will have been worth it.
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