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Cracker Squire


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Location: Douglas, Coffee Co., The Other Georgia, United States

Sid in his law office where he sits when meeting with clients. Observant eyes will notice the statuette of one of Sid's favorite Democrats.

Saturday, January 25, 2014

Estate recovery: Little-known aspect of Medicaid now causing people to avoid coverage

From The Washington Post:

Add this to the scary but improbable things people are hearing could happen because of the new federal health-care law: After you die, the state could come after your house.

The concern arises from a long-standing but little-known aspect of Medicaid, the state-federal program that provides health coverage to millions of low-income Americans. In certain cases, a state can recoup its medical costs by putting a claim on a deceased person’s assets.

Asset recovery predates the health-care law, but the legislation makes it apply to a larger pool of people.

About half of the states took an option to expand Medicaid to anyone who makes up to 138 percent of the poverty level, or $15,900 for an individual. That includes childless adults and people with significant assets besides a home, who previously had been excluded in most states.

In 1993, concerned about rising Medicaid costs, Congress made it mandatory for states to try to recover money from the estates of people who used Medicaid for long-term care, which can cost taxpayers hundreds of thousands of dollars per person.

Advocates are pressing the Obama administration to specify that new Medicaid recipients nationally should not be subject to asset recovery.

Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, said, “We recognize [the] importance of this issue and will provide states with additional guidance in this area soon.”

Part of the issue is that people who qualify for expanded Medicaid do not have the option of choosing instead to get a tax subsidy to buy private coverage on the marketplaces. In the states expanding Medicaid, the subsidies are available only to those who make more than the Medicaid income cutoff.

That means that someone just under that threshold could be subject to asset recovery, while someone who earns slightly more — up to 400 percent of the poverty level, or $45,960 for an individual — could get a federal subsidy to buy private coverage on the marketplaces, with no strings attached.

Other options are to buy insurance without a subsidy outside the marketplaces, or to be uninsured.


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