Many more people are eligible for Medicaid under the Obamacare expansion: adults with incomes under 133 percent of the poverty level. Can the government recover the expenses paid out for these new Medicaid enrollees through liens on their properties and recoveries from their estates?
The Health Affairs blog reports on how the Centers on Medicare and Medicaid Services is advising states on applying liens to consumers who are getting Medicaid under the new expansion. Elderly Americans often get their long-term care paid through Medicaid, but there has been a concern that people "would voluntarily impoverish themselves, transferring assets to their children or to others to make themselves eligible for Medicaid," the blog reports. Medicaid can impose liens on people's houses and other assets to get that long-term care paid back. Now the questions is how the rules about liens should be applied to people who are newly eligible for Medicaid under the Obamacare expansion.
The first upshot, the blog reports, is that liens can't be placed on the property of new Medicaid enrolees. The second upshot is that CMS advises states to try to recover from the estates of new Medicaid receipients who receive long-term care, but not other types of care: "In sum, most of the rules that apply to traditional Medicaid recipients with respect to [long-term care services and supplies] LTSS (except for lien requirements) are likely to apply to [modified-adjusted gross income] MAGI-eligible individuals who receive LTSS. CMS intends, however, to take steps to avoid applying estate-recovery rules to [modified-adjusted gross income] MAGI-eligible individuals who do not receive LTSS to keep this from becoming a barrier to Medicaid expansion eligibility."
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