Spousal Refusal Will Change Medicaid Law

The following is from an excellent story in the New York Times (link below).   The inability of taxpayer-paid programs (Medicaid specifically) to pay mounting bills for long-term care will mandate changes in the current system.

For that reason, the American Association for Long-Term Care Insurance urges education and advocates planning.  If you are age 50-to-60, and middle class this is especially vital.  If Medicaid (taxpayers) are strapped today … you can only imagine what it will be in 20 or 30 years.

Here’s the blurb from the NY Times and the link to the full article.

Last year, more than 1,200 people in New York City officially turned their backs on their husbands and wives to qualify for Medicaid, triple the number of people five years ago. The practice, known as “spousal refusal,” is becoming more common as the population ages and the cost of nursing care rises — and it is coming under increasing attack by government officials looking to curb ballooning Medicaid expenses.

In a recent report, Lt. Gov. Richard Ravitch warned that spousal refusal could be abused as “an entitlement for the less needy” and urged state officials to rethink it, noting that long-term care accounts for nearly half the state’s Medicaid spending.

Lawyers for the elderly argue the tactic of spousal refusal is legal nationwide, and it is most commonly used in New York and Florida, where 136 people refused to support a sick spouse last year.

Without the option of spousal refusal, lawyers say, American health care is like a ghoulish lottery. Those who need doctors’ care for illnesses like cancer or heart disease are covered by Medicare, the insurance program for the elderly, while those who need more custodial care for Alzheimer’s or stroke must pay for it themselves or dispose of their assets to qualify for Medicaid.

The federal government allows a healthy spouse to keep a house, a car, up to about $2,700 a month in income and up to about $110,000 in other resources. Anything above that must be spent on nursing care before Medicaid kicks in.


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