3 Responses to “Rep. Barber files bill to protect families receiving long-term care services”

1. Norman Spier says:

   July 8, 2020 at 3:38 pm

   Thank you so much for reporting that Massachusetts, despite claiming to be the big healthcare / Romneycare state, is one of the few that estate-recovers ordinary medical bills from its Medicaids including ACA expanded Medicaid.

   (You reported this In your: “Massachusetts is among one of the few states that goes beyond this mandate [to recover nursing homes] and collects money from all MassHealth recipients over age 55, regardless of whether they were in a nursing home”)

   The Boston Globe simply refuses to publicize this, for who knows what reason.

   With the estate recovery on ordinary health coverage Medicaids (MassHealth), people 55 to 64 who get, from the Health Connector, ACA expanded Medicaid (i.e. MassHealth, which they get if the Connector and MassHealth determine their income is <= 138% of the Federal Poverty Level), they don't get insurance.

   Bills are paid for now, but their estate is must pay back the bills when the person dies. People have only a loan until death for Medical expenses, and actually don't have insurance. This can be quite the financial bomb for people planning on passing on assets.

   It largely affects people with lower incomes, and keeps them from passing on modest assets, like maybe just a $200,000 house.

   Many states, incluidng NY, OR, WA, CT, MN, CA, CO, and recently ME corrected the problem starting in the main ACA provisions year of 2014, but somehow MA has not!

   MA claims 97% of residents are insured, but in fact, about 4% of people have a MassHealth and are 55 or older, so that the true insured rate is only about 93%. The rest have just a loan (until death).

   References:

   A good general reference is the Wikipedia article on Medicaid estate recovery. Wikipedia is not, in itself, reliable, so you need to click on the references to verify.

   —

   Otherwise, let me supply some references, including those showing that both WA and MN stopped estate recovery on non-long-term care expenses when the issue was brought up in the press. (About 6 other states did as well — you need to check the Wikipedia article for documentation for those.)

   Seattle Times article (late 2013):

   https://web.archive.org/web/20150409115216/https://www.seattletimes.com/seattle-news/expanded-medicaidrsquos-fine-print-holds-surprise-lsquopaybackrsquo-from-estate-after-death/

   Which actually led, in just a few days, to Washington State stopping estate recovery on at least expanded Medicaid, as here:

   http://blogs.seattletimes.com/healthcarecheckup/2013/12/16/state-will-change-asset-recovery-policy-for-medicaid-enrollees/

   2014 Washington Post Article (early 2014) on the general issue:

   https://web.archive.org/web/20170213022927/https://www.washingtonpost.com/national/health-science/little-known-aspect-of-medicaid-now-causing-people-to-avoid-coverage/2014/01/23/deda52e2-794e-11e3-8963-b4b654bcc9b2_story.html

   And here is also an Atlantic 2014 mention of the issue:

   https://www.theatlantic.com/politics/archive/2014/01/can-medicaid-really-come-after-you-house-when-you-die/357357/

   And here is a case of some activism in MN getting the recovery stopped in 2017

   https://www.mlstargazette.com/story/2017/05/18/news/minnesota-ma-estate-liens-put-to-final-rest/2269.html

2. Norman Spier says:

   July 8, 2020 at 3:44 pm

   I should add one other reference, for our neighbor, Maine.

   The state was late in expanding Medicaid (i.e. filling in the gap, so that everyone gets some ACA coverage), but it did do it recently.

   And after doing it, to keep people afraid of getting ACA expanded Medicaid, it stopped the estate recovery of non-long-term-care Medicaids.

   The plan to do this by the ME Governor is covered here:

   https://bangordailynews.com/2020/02/05/politics/maine-wants-to-roll-back-estate-recovery-to-spur-medicaid-expansion-sign-ups/

   (My understanding is that the bill was subsequently passed, and signed into law, though I cannot find documentation on that.)

3. Norman Spier says:

   August 2, 2020 at 12:15 pm

   Let me make real the key quote from Rep. Barber’s press release:

   ‘ Current federal law requires MassHealth (the Commonwealth’s Medicaid program) collect its costs from estates of members who received long-term care services in nursing homes. Massachusetts is among one of the few states that goes beyond this mandate and collects money from all MassHealth recipients over age 55, regardless of whether they were in a nursing home. ‘

   Let me make real the “Medicaid estate recovery on much ACA coverage obtained by applying at the Health Connector” with a recent example caught in the Washington Post in another state, Maryland, which like Massachusetts, is as another among the few states maintaining the estate recovery on non-long-term-care expenses.

   https://live.washingtonpost.com/color-of-money-live-20200723.html

   If you scroll down to “Q: Medicaid estate recovery”, you will see that Dad, living in Maryland, ages 62 to 64, got ACA’s expanded Medicaid after he lost his job, and Maryland Medicaid paid the bills for his illnesses.

   Dad thought he had real insurance.

   But, alas, when he died, at age 64, his 3 children, who also had though he had had real insurance, discovered that although Dad was among the 91% of people counted as “insured” by the U.S. Census Bureau, he actually had just a loan until death for medical expenses, and actually, had no insurance at all.

   (All bills paid out had to be paid back to the Maryland Medicaid Department by Dad’s 3 kids–that’s not insurance in any sense of the term.)

   This should also help straighten out many the common misconception that Medicaid estate recovery is only done for long-term-care and nursing home expenses. In maybe 10-14 states, including our own Massachusetts, it is done for all Medicaid medical expenses for people 55 and over.