COLUMN: Medicaid and Mom

Mom passed in 2013 after spending time in an Iowa care facility since 2006. She had many illnesses including colon cancer, congestive heart failure and a rare disorder that wouldn’t allow my sister and I to care for her ourselves. She gradually lost the use of her major muscle groups and became wheelchair bound. Ultimately, she couldn’t turn over in bed or go to the bathroom unassisted. My sister and I were working full-time.

Mom worked outside the home her entire adult life. At 65, Social Security provided $450/month and she worked until unable to continue at 72 years old. Grandma Mattie left an inheritance worth $225,000 in stocks and bonds. Mom owned a home on 10 acres. An inheritance and value of property and home were around $300,000 when entering the care center. She gratefully paid for her care. Her property and possessions were sold in 2007. Funeral expenses were pre-paid.

All assets were depleted in 3.5 years. Mom still needed care.

Medicaid was the answer. I learned that Medicaid recipients can’t have more than $2,000 in assets. Yes, $2,000 TOTAL. Social Security was her income. She worried about money and didn’t like taking “charity.”

Medicaid recipients living in care facilities surrender social security benefits to the care center and are allowed to keep $50/month for “spending money.” The week she died I asked her if I could pay for the headstone. At the time of her death, her bank account was $664.84.

Three weeks after Mom died, Iowa Medicaid called to remind me that her assets must be forwarded to them. She owed it. I didn’t receive that call well. My response was curt and through tears I indicated how awful the call was. She was told the money would be released by the bank ASAP.

It was a dark time. My understanding of the Medicaid system and those who receive it changed. Funny how personal experience does that.

· According to Iowa Medicaid statistics available from August 2024, 678,107 Iowans are enrolled in Medicaid.

· 75% of adults in Iowa on Medicaid are working.

· 32% of non-elderly Medicaid enrollees in Iowa are people of color.

· 9% of all births in Iowa are covered by Medicaid. Medicaid covers 23% of women age 16-49.

· Medicaid covers 1 in 6 adults ages 19-64 or 17% of that group and 3 in 8 children or 37% of Iowa’s children.

· 1 in 7 are Medicare beneficiaries or 14% of Medicare recipients also receive Medicaid.

· 3 in 8 working-age adults with disabilities or 37% of Iowa’s working-age population with disabilities receive Medicaid meaning 63% disabled people work.

· 1 in 2 nursing home residents receive Medicaid or 50% of Iowa’s nursing home residents are covered by Medicaid and in the same situation my mom was. Think about that fact. Half of the residents in care facilities are there because of access to Medicaid.

I wonder if the Iowa legislature or Governor took the time or cared enough to review statistics, such as these from the Kaiser Family Foundation, an independent source for health policy, polling and journalism.

If Medicaid is discontinued or reduced, do residents face eviction from care centers if they aren’t privately paid or their family can pay? What happens to care centers in rural Iowa? What happens to the staff?

What happens to rural hospitals and health care providers? Hospitals are one of the primary employers in communities and counties. What happens to the local economy when health care jobs disappear?

This isn’t just a rural issue. Urban hospitals may have up to 45% of the children treated covered by Medicaid.

Medical care providers don’t differentiate care based upon medical insurance coverage. Medicaid recipients aren’t society’s “freeloaders.” They’re a cross-section of your neighbors, young, old and in-between. 75% are working in jobs without insurance. Many may wish Medicaid wasn’t necessary, but realize it’s a God-send.

Before judging, remember, “It’s only by grace” that it isn’t you or a family member dependent upon Medicaid. I learned many lessons from Mom like, do your research, stay positive regardless of circumstance, be slow to judge, grant grace, and be grateful.

She was grateful for Medicaid and so was I.