The Free Press, Mankato, MN

State, national news

December 18, 2013

Expanded Medicaid's fine print gives middle-age adults big jolt

(Continued)

But if they were married, they calculated, they could “just squeak by” with enough income to qualify for a subsidized health plan — and avoid any encumbrance on the home they hope to leave to Prins’ two sons.

“We’re happy to be getting married,” Prins said last week. “Unfortunately not everyone has such an elegant solution to the problem.”

For Washington state, the solution has been much more complicated.

Over the past month, as lawmakers began hearing from worried and angry constituents, state officials began exploring what it would take to fix this collision of state rules with the ACA.

Late Friday, Gov. Jay Inslee’s office and the state Medicaid office said they plan to draft an emergency rule to limit estate recovery to long-term care and related medical expenses.

They hope to be able to change the rules before coverage begins Jan. 1.

Fixing the problem will cost the state about $3 million a year, said Dr. Bob Crittenden, Inslee’s senior health policy adviser, but it’s the right thing to do.

“There was no intent on the part of the ACA to do estate recovery on people going into Medicaid (for health insurance),” Crittenden said. “The idea was to expand coverage.”

People in their 50s and 60s make up about 30 percent of the adults who have signed up for health insurance through Washington’s exchange marketplace, and about 18 percent of adults who have enrolled in health insurance through Apple Health.

Some 55- to 64-year-olds, who may have taken early retirement or who were laid off during the recession, have found themselves plunged into a low-income bracket. Unlike Medicaid recipients in the past — who were required to reduce their assets to qualify — they’re more likely to have a home or other assets.

For health coverage through Medicaid, income is now the only financial requirement.

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