> I'm not sure why you're saying that using Medicaid is equivalent to accumulating debt with the Federal government. Medicaid is health insurance.

Please read the info in the link I provided. It's from the Medicaid website itself so no bias or fabrication at all.

Medicaid is not health insurance. It provides access to health services but the patient is on the hook for the cost of those services. In certain states things are a bit different. With some 64 million people enrolled in Medicaid it is probably safe to say that tens of millions of people are accumulating debt with the government.

My point of contention is that almost nobody knows this because it is swept under the rug for the political gains afforded by saying that millions more have "health insurance" when, in fact, they don't.

It also really bothers me that a good number of those in the program are poor and probably not very educated and don't realize they are signing over their estate to the government.

This really bugs me. We need to provide health services to those who cannot afford the cost and we need to do so without making an underhanded grab for what little they may possess.

This, to me, is nothing less than fraud. A private enterprise would be destroyed by lawsuits and people would end-up in jail if they had such provisions in their contracts and they were not fully disclosed ad-nauseum as a condition for entering into that contract.

Not sure why we accept this from government other than, per my findings, almost nobody knows how Medicaid actually works.

If you use Medicaid, you're expected to first deplete almost all of your financial resources to pay. It's not unusual to even have your home become an asset that will be eventually taken by the government.

After ACA this is no longer true in Medicaid expansion states.

There is no asset test, and there is no paying back benefits if you are under 65 when you took them.

Medicaid expansion is quite literally the best insurance that money can't buy.

In CA, for example, a family of 4 earning less than $33,500 gets MediCal [1]. If you just want free coverage for the kids, you can earn $64,600. [2]

[1] - http://www.dhcs.ca.gov/services/medi-cal/Pages/DoYouQualifyF...

[2] - http://hbex.coveredca.com/toolkit/renewal-toolkit/downloads/...

ACA is likely about to be repealed.

And maybe that's a good reason why it should be.

A progressive tax system should not be paired with a regressive subsidy as massive as ACA. It adds up to nearly a 100% tax on the first $60,000 of income for unhealthy / chronically ill families, and a 60% effective tax rate for healthy ones.

I'm actually quite aware of this (my partner used to do nursing home placements). But if you're going into a nursing home, the implication is that you will never need those assets again. While I don't agree with this process, it's difficult to argue it is without merit. I suppose if survivors wanted to inherit those assets, they could take on the care of their elderly family members.

It's also worth noting that, in most of the US, the alternative to medicaid was/is filial support laws, in which the nursing home could take the assets of the children of the patients in their care.

The point is that people on Medicaid don't really have health insurance. They have a line of credit with the government. They are accumulating debt. In most -not all- states the law requires the state to collect on the debt. Again, by law. They can and do place liens on your property, etc.

This is very, very far removed from the idea of health insurance. Your property becomes the property of the government. With real health insurance nobody places a lien on your home for medical services rendered.