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So far I have not seen a reply to underlying question of:

If did a Medicaid spend down which brought in remaining significant IRA's ( think $1-2 hundred thousand for f/t aides, nursing home etc) and now only asset is ~~$1,000 . (ongoing SS goes to nursing home less $75/month)

 

What to do with Federal tax due of tens of thousand (even after significant  Sch A. medical deduction) and State ( no deductions allowed)?

No way to pay current tax due  NOR have any cash to pay in future.