Surprise! Medicaid isn't free- it's a poorly advertised predatory loan
Surprise! Estate Recovery under Medicaid is not really a surprise. It has been a fact for some benefits ever since Medicaid was born in 1965. {1} Later, in 1993, federal law required all states to recover Medicaid benefits paid for all long-term care and other related costs from the estates of deceased Medicaid recipients 55 or older and, optionally, to recover all other Medicaid expenses. Therefore, it should be noted, the Affordable Care Act did not change any existing federal law nor did it alter any state’s policies regarding Estate Recovery. In fact, before 2007 not all states had a Medicaid estate recovery Program. {2}
The Affordable Care Act does enlarge the window of eligibility for Medicaid to include more Americans age 55 to 65, and, by eliminating asset testing, it may increase the estates in a limited number of states that may be subject to Medicaid expense recovery after a beneficiaries die.
As it turns out, Mr. Laurie has neglected to mention a few other significant facts.
The results of Medicaid recovery policies have varied widely from state to state and not all states pursue estate recovery beyond the costs of long term care facilities and their related expenses. According to a report released by AARP in 2005, only 0.13-% of all Medicaid spending was recouped during the year 2003. It is true that the law enacted in 1993 allows estate recovery beyond the costs of long term facilities to include all other “items or services under the state plan.” However, only twenty-five states actually recovered “all other items under the state plan”; just 10 states recovered “some other items”; and 10 states did not attempt to recover any of the benefits beyond those for long term care.{3}
Americans who are eligible for Medicaid under the new ACA rules should keep in mind that only some states look to recover benefits beyond those paid for long term care. Furthermore, the 1993 federal law bars estate recovery when there is a surviving spouse, a child under the age of 21 or a child of any age who is blind or disabled. In addition, other exemptions are in place to permit family members to keep the family homestead under prescribed circumstances.
Finally, the facts remain that the Affordable Care Act did not establish Medicaid’s estate recovery rules nor did it revise them in any way. Most states do not attempt to recover benefits not paid for long term facilities. And, the ACA is expanding access to health care insurance to millions of previously uninsured low-income Americans.
{1} http://aspe.hhs.gov/daltcp/reports/estaterec.htm#note6
{2} http://www.legislature.mi.gov/(S(krbxxiqqz5qwt255s45th4us))/mileg.aspx?page=GetObject&objectname=mcl-400-112g
{3} http://assets.aarp.org/rgcenter/il/2005_06_recovery.pdfHealth insurance premiums vary from state to state. In New York, the average premium for individual coverage is half of what it was before the ACA. {1}
“Minnesota has the lowest unsubsidized prices—and is the only state where middle-tier “silver” plans come in at under $200 a month. Monthly premiums for the state’s cheapest “bronze” plan (the lowest tier of coverage) average $144. In Wyoming, meanwhile, the cheapest bronze plans average $425, and silver plans start at $489.” {2}
The ACA may be the law of the land but premiums, like auto insurance, are going to vary according to local conditions. If your premiums have tripled after the ACA was enacted, you could ask your state insurance department for an explanation.
{1} http://money.cnn.com/2013/07/17/news/ec … -new-york/
{2} http://www.marketwatch.com/story/the-50 … 2013-09-27
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