Both Obamacare supporters and critics are warning that a long-standing federal law allowing states to recover Medicaid payments from the estates of deceased beneficiaries may discourage lower-income Americans from enrolling in the expanded Medicaid program.
Since 1993, federal law has required states to recover Medicaid payments for nursing home, long-term care and home- and community-based services from the estates of deceased Medicaid recipients who started receiving such benefits at age 55 or older. But the law also gave states the option to recover other types of Medicaid costs, including medical services. Some states, such as California, have taken that option and have collected for medical costs as well as long-term-care costs.
Now it's unclear whether the more than two dozen states that have expanded Medicaid will go after the estate assets of low-income residents who enroll in the expanded program, which under the Patient Protection and Affordable Care Act makes Medicaid coverage available to adults with incomes up to 138% of the federal poverty level with no asset test. According to a Consumer Reports article, 10 Medicaid expansion states plan to go after assets, 11 do not, and the intentions of four states plus the District of Columbia are not yet known.