Saturday, June 22, 2013

While The Poor Get Poorer

With the Medicaid Expansion mandated by the Affordable Care Act comes a very disturbing issue. New York State chose to offset it's costs by switching all Medicaid to HMO insurance. This is turning out to be just another way to punish people for getting old and needing help.

It seems that our county has more than it's share of elderly and disabled receiving Meals On Wheels. Since the HMO now makes the rules, they have decided in their infinite wisdom that a well balanced meal delivered to the elderly isn't something that they want to pay for, so NO Medicaid recipient who has been receiving those meals will continue to do so unless they wish to pay out of their own pockets for them. Cost of the meal? Try $7.75 a day.

I'm of two minds about this. There's a part of me that wants to be outraged over all this and another part of me that is amused by the necessity for neglectful family members to actually have to do something for their parent. Case managers for the county are contacting family members to explain this situation and they are telling them what the solution is going to be. There are options involved.

1. Pay for the MOWs themselves if the client can't.

2. Spend some time at the parent's home cooking a weeks worth of meals, portion them out so that said parent can reheat in the microwave.

3. Make sure that parent has his/her EBT card available or enough money so that the aide that Medicaid HMOs are willing to pay a couple of extra hours per week can shop and cook for the parent.

Personally, out of sheer selfishness I'm hoping for the third option. I need more hours.

Strangely, my experience has been that the low income families will step up and handle the hot meal situation themselves even though it presents quite a burden for them. It's the more affluent families that seem to feel they don't owe their parents a damn thing. When I began to notice that trend I thought it was my imagination, however, the owner of a rival home care company says the same thing.

It seems that Generation Xers, or The Millennials, whichever you prefer, are firm believers that life is all about ME. So what if Mom and Dad sacrificed their own desires to raise them? They didn't ask them to do that. They didn't even ask to be born. Just once I'd like to say something along the lines of "Look at how much more money they'd have in retirement if your parent's hadn't fed you, clothed you, put you thru college and bailed your selfish little asses out every time you maxed out your credit." I'm not allowed, for which I am eternally sorry.

I need the work. I'm about to start the SNAP Challenge, not as an exercise in curiosity. I've lost close to $400/ month income with the uncertainty around what Medicaid will now cover. Hubs business only took in $10,000 in the past 3 months, and having to spend $4500 of that to put another engine into the pumper truck he needs in order to make that money, screwed us out of any income from that at all. I can't count on his income to cover what it has in the past.

The only bill other than basic living expenses we have is the satellites and I can't disconnect the internet satellite since I need it to file the NYS taxes on his business that are now e-file only. So, the belt tightening must come from the food budget.

Instead of going to my favorite grocer where you can find some decent deals but prices are kind of high, I went to Aldi's. After today I'm impressed with their fresh produce, if I stay that way remains to be seen. Prices were considerably lower than in any other store and I was able to buy a weeks worth of groceries for $35.04. I went to Walmart for the cat food and out of my $50 budget, I have $5 left over. That will buy me my organic steel cut oatmeal so I can continue to start my days on a healthy note. I have blueberries to add to tomorrow's bowl. Regular price in the usual store is $2.89. Price at Aldi's for the same pint was $1.69. I don't know about anyone else, but I call that a WIN!


  1. Squaltlo,
    Mom is 88 and has mild dementia - I see she has breakfast and lunch and supper (usually microwave that she can do. I do not allow her to do anything on the stove top. Mom has me.
    What about those that don't have anybody to do what I do for Mom?
    I don't think Meals on Wheels is as much about ability to buy food as it is ability to prepare food. If meals on wheels goes away - what is the next step - the nursing home.
    I ask you what is more cost effective?
    New York will take it in the ass on this...

    Oh, I love ALDI. Do you know that they are German owned? Check out the Shrimp Lo Mein -
    not bad...


    1. Sarge,

      Medicaid is willing to pay for 2 hours every week for an aide to cook meals that can be reheated in a microwave for people without families. Not sure about with families, it seems that may fall to them to do it and that shouldn't be that hard.

      My problem is how neglectful many families are. It's heartbreaking.

  2. Sherry,
    Shit happens...
    Good post.



    1. LOL, figured out I'm not Squatlo did you?

      Yup, shit happens.

  3. Replies
    1. It's going to take awhile for all the dust to settle and I figure out where I'm at. In the meantime, nobody is getting new cases except from the VA, and they're giving those to aides who want to work full time. Hopefully, they'll find cases for us part timers soon.

  4. We try to suppliment with a small raised bed and plants in containers.
    the Ol'Buzzard

    1. We've tried that too. Gotten almost nothing out of it between the bugs, rabbits, and other vegetarian wild things. The year we tried bloodmeal the foxes and coyotes tore everything up. I'll just have to be content with Aldi's until I can see what homegrown will be selling for locally.

  5. It is a grab bag of choices and compromises we have to work through with out parents and ourselves.

    1. I can see this neglect if my clients have young grandkids, but most of them have great grandkids and they still are neglected by their soon to be retired adult kids.

      I have 1 client whose daughter is a nurse. She left us without cleaning supplies for over a month and no money in the clients home to do laundry with. She works 3 days 12 hours which gives her 4 days off to find 1 day to address her Mom's issues. It's sad.

  6. Sherry,
    I am at