Fears of asset recovery deter Medicaid enrollment

Some Americans are declining Medicaid enrollment because they're afraid the government will swoop in after they die and seize their homes to recover medical costs, in keeping with a longstanding program prerogative. Affordable Care Act critics are having a field day with this possibility, calling it the "Medicaid asset seizure bonanza," The Washington Post reported.

"When it comes to something as central to middle-class identity as a home and what people can pass on to their heirs, it is perhaps not surprising that some people are not taking any chances," the Post wrote.

It's an obscure but real threat: Last year, the Tennessee Supreme Court ruled that the state's Medicaid program could pursue the willed property of deceased beneficiaries who received long-term or nursing home care, as FierceHealthFinance reported. And in other healthcare circles, mining patients' estates has been an effective debt reduction tactic.

The Centers for Medicare & Medicaid Services acknowledged Medicaid asset recovery apprehensions and agreed to issue guidance on the matter, the Post noted.

Congress has required states to initiate asset recoveries after Medicaid paid long-term healthcare expenses, which can cost hundreds of thousands of dollars per person. The leading argument for recovery is that "if you're receiving a public benefit and the state is trying to support you, you should give back if you are able," Oregon Medicaid Director Judy Mohr Peterson told the Post. Experts say state approaches to Medicaid asset recovery vary widely.

Asset seizure possibilities notwithstanding, citizens in some parts of the country are clamoring for Medicaid enrollment. Low-income Nebraska residents, for example, are pushing for "a rewritten Medicaid proposal" to prompt another Medicaid expansion debate in their state legislature, the Associated Press reported. This move is opposed by GOP lawmakers who consider Nebraska's rejection of Medicaid expansion a settled question, the article noted.

For more:
- see The Washington Post article
- read the AP article

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