Medicaid expansion means states may go after more Americans' assets to recover costs

April 11, 2015

For more than 20 years, federal law has allowed states to recover almost all Medicaid costs if recipients are 55 or older when they die, a rule that now applies to many of the 11 million people who joined Medicaid since the ACA's expansion of the program in 28 states. As a result, some families are discovering they may have to sell a home or other assets of a deceased relative to reimburse the government. Prior to Medicaid expansion, in fiscal 2011, states recovered almost $498 million from the estates of Medicaid recipients who died, according to a report by the OIG. The recovered funds are divided between a state and the U.S. based on the portion of the Medicaid budget Washington provides. Some lawmakers and advocates are pushing to further restrict the practice. Colorado, Connecticut, Oregon and Washington scaled back what costs they attempt to recover from estates, and California is weighing legislation to help protect survivors' assets. CMS has said it intends to explore options to eliminate the recovery of Medicaid benefits for services other than long-term care and related costs.