When Medicaid comes after the family home

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The letter got here from the state Department of Human Services in July 2021. It expressed condolences for the lack of the recipient’s mother, who had died a number of weeks earlier at the age of 88.

He then explained that the decedent had a Medicaid debt of over $77,000 and provided instructions on methods to repay the money. “I was stunned,” said the woman’s 62-year-old daughter.

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At first she thought the letter could be some type of scam. It was not.

She asked to stay anonymous because the case is unresolved and she or he doesn’t need to jeopardize her possibilities of reducing the bill. The New York Times has reviewed documentation confirming her account.

The daughter had moved to the family home in the Midwest a few years earlier when her widowed mother, who suffered from vascular dementia, began to need assistance.

Her mother was well insured, with Medicare, a personal “Medigap” supplemental policy, and long-term care insurance. The only reason she signed up for Medicaid was because she was enrolled in a state program that allowed her daughter to receive modest advantages for her care.

However, this resulted in additional monthly payments through the Medicaid managed care organization, and now the state wants that a refund.

This practice dates back to 1993, when Congress mandated that Medicaid beneficiaries over the age of 55 receive long-term services, comparable to nursing homes or home care, Member States must try to get better this expenditure from the estates of the heirs after their death.

“Medicaid requires beneficiaries to spend almost all of their assets” to qualify for advantages, explained Eric Carlson, managing attorney at Justice in Aging.

Most states allow people eligible for Medicaid to maintain assets value as little as $2,000. However, if the beneficiary is the homeowner, she or he could also be exempt.

However, if Medicaid pays for long-term care and there’s money available after death, state agencies will come after the assets.

“If there are tens of thousands of dollars to recover, in most cases it will be a house,” Mr. Carlson said. Surviving family members can have to sell the house to repay Medicaid, as the Midwestern daughter could also be forced to do, or the state may foreclose on the property.

Medicaid “is the only public benefit program in the United States that requires states to seek reimbursement,” said Representative Jan Schakowsky, an Illinois Democrat. This month, she re-introduced the so-called bill Stop the unfair Medicaid Recovery Actto finish the practice.

Its staff calculated that as of 2021, 17,000 families in Illinois alone had lost their homes because of this of Medicaid recovery. Comparable national data should not available, but independent agency which advises the federal government and states on Medicaid issues reported in 2021 that states collected $733 million in asset recovery in fiscal yr 2019.

That represents only about half a percent of Medicaid long-term care spending, based on the agency, MACPAC, the Medicaid Payment and Access Commission and CHIP. Only eight states collected greater than 1%. expenses.

“This is a truly harmful and cruel program,” Ms. Schakowsky said. “And it doesn’t work. The cost of actually trying to recover the money may exceed the amount that will be refunded.”

When Congress established the mandate, supporters argued that asset recovery would get monetary savings and promote fairness because some higher-income seniors hired lawyers to assist protect their assets in order that Medicaid could cover nursing home bills.

But for the most part, states pursue claims against low-income families, a lot of whom are black and Latino. Critics say the policy perpetuates poverty. MACPAC’s report shows that the average estate of deceased Medicaid beneficiaries over the age of 65 is lower than $45,000 and the average home equity is $27,364.

“For many of these people, a home is the result of a lifetime of work and saving,” Mr. Carlson said. “It could be a foundation for their children and grandchildren. This was taken from the family under these claims. It imposes restitution on families and communities least able to pay it back.”

(A surviving spouse, minor, or disabled child may proceed to live in the home after the Medicaid beneficiary dies, but recovery can begin after the survivor dies or the child turns 21.)

Every state offers hardship waivers that reduce claims, but “the process is usually difficult or futile,” Carlson said. “Depending on the state, the request will almost always fail.”

“I don’t think asset recovery was a policy designed primarily to impact low-income families, but that is what it does have,” said Natalie Kean, one other lead attorney at Justice in Aging.

However, wealth recovery may affect middle-class families. Many people turn to Medicaid because, given the costs of nursing homes (so-called the average price last yr was $8,669 monthly), “Your savings could disappear quickly,” Carlson said.

Brian Snell, a senior attorney in Marblehead, Massachusetts, represents a family whose 93-year-old mother, who suffered from dementia, died in 2022 in her North Andover apartment. Her daughter cut her hours as a beautician to take care of her at home, wanting to maintain her out of the nursing home because “that’s what her mother wanted,” Mr. Snell said.

When the mother qualified for the state’s MassHealth Medicaid program, she enrolled her in the state’s home health program, which provided home health care assistance (though only sporadically, as the pandemic made staff and agencies reluctant to enter homes). .

After her death, MassHealth sought to get better $292,000 in home care costs and program premiums. Because her two children, including her daughter, were low-income, a state waiver would allow them each to receive $50,000 from the sale of their mother’s apartment. But greater than half of the $335,000 sale price will go to the state and federal governments.

The prospect of such reimbursements prevents some low-income older adults from receiving the care they need, even in the event that they are eligible for it.

“It is not uncommon for people to simply decline to apply for Medicaid services once they learn about the recovery program,” Matthew Portwood, admissions manager for the Atlanta Regional Commission, which serves as the local agency for Medicaid, said in an email. aging. “Our advisors see this almost every day.”

Some states are working to cut back the financial impact on low-income families. For example, Massachusetts, Georgia, South Carolina and Illinois won’t pursue claims for property value lower than $25,000. Some states now provide applicants with more complete explanations regarding the consequences of registration.

California allows relief from difficulties for a “homestead of modest value,” defined as a market value of as much as one-half the average price of homes in the county. MACPAC really useful changing federal law to permit states to make recovery optional.

Representative Schakowsky’s bill goes beyond this and completely prohibits asset recovery under Medicaid. “It’s just a terrible idea,” she said.

Her bill faces a tricky fight in the Republican-controlled House of Representatives – all 13 of its co-sponsors are Democrats – and when she introduced it last session, it went nowhere. But the congresswoman stays optimistic: People in red states also need long-term care.

Back in the Midwest, the daughter who was paid $77,000 still hopes to remain in the two-story house where she grew up, where her mother lived for greater than 60 years and where “there’s a memory in every corner.” Now he’s searching for a lawyer. “I have to fight it,” she said.

Rome
Romehttps://globalcmd.com/
Rome: Visionary Founder of the GlobalCommand Ecosystem (GlobalCmd.com | GLCND.com | GlobalCmd A.I.) Rome is the innovative mind behind the GlobalCommand Ecosystem, a dynamic suite of platforms designed to revolutionize productivity for entrepreneurs, freelancers, small business owners, and forward-thinking individuals. Through his visionary leadership, Rome has developed tools and content that eliminate complexity, empower decision-making, and accelerate success. The Powerhouse of Productivity: GlobalCmd.com At the heart of Rome’s vision is GlobalCmd.com, an intuitive AI-powered platform designed to simplify decision-making and streamline workflows. Whether you’re solving complex business challenges, scaling a new idea, or optimizing daily operations, GlobalCmd.com transforms inputs into actionable, results-driven solutions. Rome’s approach is straightforward yet transformative: provide users with tools that deliver clarity, save time, and empower them to focus on growth and achievement. With GlobalCmd.com, users no longer have to navigate overwhelming tools or inefficient processes—Rome has redefined productivity for real-world needs. An Ecosystem Built for Excellence Rome’s vision extends far beyond productivity tools. The GlobalCommand Ecosystem includes platforms that address every step of the user’s journey: • GLCND.com: A professional blog and content hub offering expert insights and actionable advice across business, science, health, and more. GLCND.com inspires users to explore new ideas, sharpen their skills, and stay ahead in their fields. • GlobalCmd A.I.: The innovative AI engine powering GlobalCmd.com, designed to turn user inputs into tailored recommendations, predictive insights, and actionable strategies. Built on the cutting-edge RAD² Framework, this AI simplifies even the most complex decisions with precision and ease. The Why Behind GlobalCmd.com Rome understands the pressure and challenges of running a business, launching projects, and making impactful decisions in real time. His mission was to create a platform that eliminates unnecessary complexity and provides clear, practical solutions for users. Whether users are tackling new ventures, refining operations, or handling day-to-day decisions, Rome has designed the GlobalCommand Ecosystem to meet real-world needs with innovative, results-oriented tools. Empowering Success Through Simplicity Rome’s ultimate goal is to empower individuals with the right tools, insights, and strategies to take control of their work and achieve success. By combining the strengths of GlobalCmd.com, GLCND.com, and GlobalCmd A.I., Rome has created an ecosystem that transforms how people work, think, and grow. Start your journey to smarter decisions and greater success today. Visit GlobalCmd.com and take control of your future.

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