It seems like you have gone beyond our ability to advise you, if you (she) can't pay the 2024 tax, have no expectation to be able to pay the tax in the future, and have no assets left to pay it with.
I recommend that you contact a local tax professional who is very familiar with your state's Medicaid rules, and who is also familiar with Offers in Compromise with the IRS in order to get you out of your situation.
This is a good time to reach out to everyone you know to get a good recommendation.
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