Document Type
Article
Publication Date
Fall 2024
Abstract
This Article examines the Medicaid estate recovery program and argues that its current notice framework fails to provide meaningful disclosure to Medicaid enrollees regarding the financial consequences of long-term services and supports (LTSS) coverage. Although Medicaid insures approximately one in five individuals in the United States, it uniquely requires certain beneficiaries—primarily individuals age fifty-five or older receiving LTSS—to repay covered costs from their estates after death. Federal law mandates recovery but does not require states to inform applicants or enrollees of anticipated or accrued estate recovery costs during their lifetimes. As a result, families frequently receive notice of substantial recovery claims only after the enrollee’s death, often jeopardizing the family home and creating significant emotional and financial distress. The Article contends that this lack of transparency undermines informed decision-making and effectively transforms Medicaid from an entitlement into a posthumous loan. It further highlights the heightened concern in managed care states, where estate recovery claims may be based on capitation payments rather than actual service utilization. To remedy these deficiencies, the Article proposes a federal statutory amendment requiring states to provide clear, periodic notice of estimated and accrued estate recovery obligations to Medicaid applicants and enrollees. Such reform, the author argues, would promote informed consent, align estate recovery with broader consumer protection principles, and safeguard vulnerable populations as demand for long-term care continues to rise.
Recommended Citation
Ashley Bassel Griffith, Hidden until the End: The Need to Inform Medicaid Enrollees of Estate Recovery Costs before Their Death, 32 Geo. J. on Poverty L. & Pol'y 1 (Fall 2024).
Included in
Estates and Trusts Commons, Health Law and Policy Commons, Legal Writing and Research Commons
