Dear Mom,

You won't comprehend this because you have Stage 6 Dementia, but things need to change. The nice congressmen in Washington want to free us from government dependency so we can make better healthcare choices without the stigma of taking handouts from society.

So, Mom, about your Medicaid Aged and Disabled Waiver that pays me a 40 hr/week pittance to care for you at home 24/7: the new HHS Secretary and Medicaid Chief sent our Governor a letter that says people on Medicaid should seek employment if they want to keep those benefits. This may sound unfair considering you're 89, bladder and bowel incontinent, unable to walk unassisted, and often lapse into episodes of uncontrollable whimpering, but if the government decides it's for the best, we'll all need to buck up and contribute our fair share. After all, your 50 year nursing career doesn't necessarily entitle you to a free ride.

I'll probably need to get a "real" job too, because I exploit the system. Never mind that your care would cost the state $78,000 annually in a nursing home versus the $16,000 it pays me; leave the math to those smart fellas in Washington who understand that big government should stop controlling our lives. The important thing is we'll have freedom to choose, and not impose an unfair tax burden on millionaires and the medical industrial complex.

Once I stop taking handouts, I won't be home with you. We should bolster the economy by hiring attendant care, but it costs more than I can earn, and Medicare won't cover it because those warmhearted legislators support family values like looking after our own. You'll enjoy being home alone all day, Mom. You don't really need regular meals or clean Depends, and when you have one of your falls, you can rest quietly on the floor in a puddle of urine until I get off work. Those dear congressmen give us other options, too, such as permanently placing you in a facility to die more quickly and efficiently. Here's another choice: I could stay home and attend you for free! We'll do fine on your Social Security income by sacrificing a few luxuries like groceries, property taxes, electricity, and the car.

There's a bonus, Mom. I won't be forced to maintain health insurance! Remember “Obamacare” that saved my life through early cancer screening? The Republicans devised a better plan. Because I'm over 50 and earn $150 per year above the Medicaid cutoff, my annual premium will increase by roughly $6,000, but I can choose to opt out! I'll still have "access” but not be victimized by the enslaving tax subsidy that let me afford coverage for the first time in 25 years. I'm excited about returning to indigent emergency room treatment and boosting insurance industry profits while taxpayers shoulder the cost instead.

With so many great options it's hard to decide, but here's our new plan, Mom. Under Trumpcare, I'll "choose" to lose health coverage, seek a minimum wage job, and dump you in a nursing home. Between the cost of facility care, a couple of ER visits and perhaps one minor surgery for me per year, and the food stamps and heating assistance I'll need once you and your Social Security income leave the household, I estimate we will save the government roughly NEGATIVE $350,000 over the next 5 years! Multiply that by the millions of people who will lose coverage, and you can appreciate what a sensible and economical plan the Republicans have devised.

You'll be proud to receive depersonalized institutional care instead of burdening society in comfort with your family. The facility gets your Social Security check, and Medicare/Medicaid will cover the balance until you hit the newly proposed block grant funding cap. If you're still alive then, we're unsure what will happen, but we can trust Congress to do what's right. I hear they're formulating a plan to ship the poor, elderly, and chronically ill to arctic ice floes. It's called “Trump Tower North: the Last Resort.” You might even get to see polar bears before they become extinct! Won't that be fun?

I'm so happy that the government wants to stop interfering in our lives.

Love,

Your Freeloading Daughter

P.S. Mom, if you do need a job to keep that Medicaid, I thought of a placement for someone who can't function productively, has no grasp of reality, and relies on government entitlements. 435 congressional seats will open up next year. You appear to be perfectly qualified.