Truth And Action

WA Medicaid + Obamacare: Seize Your Assets After Death

WA Medicaid + Obamacare: Seize Your Assets After Death

Expanded Medicaid’s fine print holds surprise in the state of Washington: after death the state can seize your assets for normal Medicaid expenses.

So, after your forced into Medicaid by Obamacare, the state can come along and bill you after death for normal Medicaid expenses.

Dr. Jane Orient, executive director of the politically conservative Association of American Physicians and Surgeons, sums it up: its  “ a cash cow for states to milk the poor and the middle class.”

“People will think this is wonderful, this is free insurance,” Orient states “They don’t realize it’s really a loan, and is secured by any property they have.”

It wasn’t the moonlight, holiday-season euphoria or family pressure that made Sofia Prins and Gary Balhorn, both 62, suddenly decide to get married.

It was the fine print.

As fine print is wont to do, it had buried itself in a long form — Balhorn’s application for free health insurance through the expanded state Medicaid program. As the paperwork lay on the dining-room table in Port Townsend, Prins began reading.

She was shocked: If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.

The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs, Prins said.

With an estimated 223,000 adults seeking health insurance headed toward Washington’s expanded Medicaid program over the next three years, the state’s estate-recovery rules, which allow collection of nearly all medical expenses, have come under fire.

Medicaid, in keeping with federal policy, has long tapped into estates. But because most low-income adults without disabilities could not qualify for typical medical coverage through Medicaid, recovery primarily involved expenses for nursing homes and other long-term care.

The federal Affordable Care Act (ACA) changed that. Now many more low-income residents will qualify for Medicaid, called Apple Health in Washington state.

But if they qualify for Medicaid, they’re not eligible for tax credits to subsidize a private health plan under the ACA, which requires all adults to have health insurance by March 31.

Prins, an artist, and Balhorn, a retired fisherman-turned-tango instructor, separately qualified for health insurance through Medicaid based on their sole incomes.

But if they were married, they calculated, they could “just squeak by” with enough income to qualify for a subsidized health plan — and avoid any encumbrance on the home they hope to leave to Prins’ two sons.

“We’re happy to be getting married,” Prins said last week. “Unfortunately not everyone has such an elegant solution to the problem.”

For Washington state, the solution has been much more complicated.

Over the past month, as lawmakers began hearing from worried and angry constituents, state officials began exploring what it would take to fix this collision of state rules with the ACA.

Late Friday, Gov. Jay Inslee’s office and the state Medicaid office said they plan to draft an emergency rule to limit estate recovery to long-term care and related medical expenses.

They hope to be able to change the rules before coverage begins Jan. 1.

Fixing the problem will cost the state about $3 million a year, said Dr. Bob Crittenden, Inslee’s senior health-policy adviser, but it’s the right thing to do.

“There was no intent on the part of the ACA to do estate recovery on people going into Medicaid (for health insurance),” Crittenden said. “The idea was to expand coverage.”

Unpleasant surprise

People in their 50s and 60s make up about 30 percent of the adults who have signed up for health insurance through Washington’s exchange marketplace, and about 18 percent of adults who have enrolled in health insurance through Apple Health.

Some 55- to 64-year-olds, who may have taken early retirement or who were laid off during the recession, have found themselves plunged into a low-income bracket. Unlike Medicaid recipients in the past — who were required to reduce their assets to qualify — they’re more likely to have a home or other assets.

For health coverage through Medicaid, income is now the only financial requirement.

At first, Prins was pleased at the prospect of free coverage.

But the more she thought about the fine print, the more upset she got. Why was this provision only for people age 55 and older? Why should those insured by Medicaid have to pay back health expenses from their estates when people with just a bit more income who get federal subsidies don’t? Why didn’t she and Balhorn know about this before getting to the application stage?

As Prins began searching for answers, she found that even those trained to help people sign up for insurance under the ACA weren’t aware of this provision, nor were some government officials.

Around the country, the issue has sizzled away in blogs and commentaries from both right and left. The National Women’s Law Center noted the ACA and its regulations prohibit age discrimination in programs such as Medicare and Medicaid.

Dr. Jane Orient, executive director of the politically conservative Association of American Physicians and Surgeons, writing in the The Washington Times, called the recovery provision “a cash cow for states to milk the poor and the middle class.”

“People will think this is wonderful, this is free insurance,” Orient said in an interview. “They don’t realize it’s really a loan, and is secured by any property they have.”

Source: seattletimes.com

181 Comments

  1. Truth And Action
    Truth And Action August 13, 16:49

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    From: http://www.truthandaction.org/wa-medicaid-obamacare-seize-your-assets-after-death/comment-page-4/#comment-424962

    Reply to this comment
  2. directorsblog.health.azdhs.gov
    directorsblog.health.azdhs.gov August 13, 16:49

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  3. Lisa Hawks
    Lisa Hawks August 13, 19:48

    such bs…gonna screw the people no matter what

    Reply to this comment
  4. Laura Jean Cray-Radomski
    Laura Jean Cray-Radomski August 14, 03:32

    Ahhhhhh! WHEN WILL WE GET RID OF THIS GUY?

    Reply to this comment
  5. Chris Awol
    Chris Awol August 14, 05:19

    Stupid…..

    Reply to this comment
  6. Barb Weber
    Barb Weber August 14, 07:28

    So Medicare is Obamacare? I’m wondering now.

    Reply to this comment
  7. Tim Weir
    Tim Weir August 14, 08:34

    Families need to disburse the estate before they can get their damn hands on it!

    Reply to this comment
  8. Daisy Reynolds
    Daisy Reynolds August 14, 09:38

    Washington is the most money hungery state in the us

    Reply to this comment
  9. Annie A Lien
    Annie A Lien August 14, 11:23

    Is there any other states that do this?

    Reply to this comment
  10. Garrey McVicker
    Garrey McVicker August 14, 16:43

    if one state has it they all might

    Reply to this comment

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