The Role of the Stop Unfair Medicaid Recoveries Act

Current federal regulations require Medicaid programs run by states to try to recoup the cost from estates of recipients who have since passed away even if the state would rather not pursue such recovery. 

Medicaid programs must pursue compensation for the cost of nursing home services as well as home and community-situated services in addition to other associated services if a person who receives Medicaid was at least 55 at the time the services were provided. States have the choice to pursue recovery for other services due. The recovery is restricted by the size of the deceased individual’s estate. No other public benefit program requires that correctly paid benefits be received from a deceased Medicaid recipient’s family members. The minimum revenue created by estate recovery is surpassed by the burden it places on low-income individuals. The burden unfairly falls on families whose loved one’s experience 

The Stop Unfair Medicaid Recoveries Act was introduced by an Illinois representative and if passed into law would revise the Social Security Act’s Title XIX to repeal requirements that states create a Medicaid Estate Recovery Program and restrict the circumstances when a state can institute a lien on property owned by a Medicaid beneficiary. 

The Role of Social Security Act’s Title XIX

Medicaid was authorized through the Social Security Act’s Title XIX. The measure was signed into law by President Johnson in the late 1960s. Medicaid functions as a program run by states and the federal government and exists to provide health care services to people with low income. Medicaid also provides health services to individuals who are disabled. Each state as well as territories and the District of Columbia are required to satisfy certain elements to obtain matching funds from the government to participate in Medicaid. The match rate is influenced by each state’s poverty level. 

Medicaid is complex but operates in a basic way. The governor of each state appoints a Medicaid agency for creating as well as submitting a state plan. These plans are documents that describe how states will oversee Medicaid programs. Each state plan documents what individuals will cover as well as what services will be provided and what administrative duties are necessary to execute these healthcare services. States ultimately send plans to the Centers for Medicare and Medicaid Services, which review and then approve the plans.

Response to the Measure

The Stop Unfair Medicaid Recoveries Act has received substantial support. Congresswoman Jane Schakowsky has stated that the country lacks a long-term care policy and that the measure would valuably prohibit states from going after the surviving loved ones of Medicaid recipients who pass away. Other groups have also expressed support for the measure. An attorney for the Justice in the Aging organization has stated that the policy will stop Medicaid from forcing the sale of family homes so low-income individuals need not risk their family homes to receive necessary care. The California Advocate for Nursing Home Reform has expressed support for the measure and stated that the bill is a good idea because it will stop punishing the elderly and disabled who cannot pay for private medical care. 

Contact Information