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Implications of the expiration of Medicaid long-term care spousal impoverishment rules for community integration
Implications of the expiration of Medicaid long-term care spousal impoverishment rules for community integration
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Musumeci, MaryBeth, author
Chidambaram, Priya, author
Watts Molly O'Malley, author - Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- San Francisco, CA : Henry J. Kaiser Family Foundation, November 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Long-Term Care -- economics
Medicaid -- economics
Income
Spouses
United States - Genre(s):
- Technical Report
- Abstract:
- Seniors and people with disabilities or chronic illnesses may need long-term services and supports (LTSS) for help with self-care tasks (such as eating, bathing, or dressing) and household activities (such as preparing meals, managing medication, or housekeeping). Medicaid is the primary payer for LTSS, covering over half of national spending on nursing home care and home and community-based services (HCBS) as of 2017. To financially qualify for Medicaid LTSS, an individual must have low income and limited assets. When one spouse in a married couple needs LTSS, Medicaid spousal impoverishment rules protect some income and assets to support the other spouse's living expenses, in an effort to prevent her "financial devastation from paying the high cost of [her spouse's] nursing home care." Since Congress enacted the spousal impoverishment rules in 1988, federal law has required states to apply them when a married individual seeks nursing home care. Prior to 2014, states had the option to apply the rules when a married individual sought home and-community based waiver services. However, from January 1, 2014 through December 31, 2019, Section 2404 of the Affordable Care Act (ACA) has required states to apply the spousal impoverishment rules to HCBS waivers. Section 2404 also expanded the spousal impoverishment rules to the Section 1915 (i) HCBS state plan option, Community First Choice (CFC) attendant care services and supports, and individuals eligible through a medically needy spend down. If Congress does not reauthorize Section 2404, the spousal impoverishment rules will revert to a state option for HCBS waivers and will not apply to other HCBS, as of January 1, 2020 (Figure 1). This issue brief answers key questions about the spousal impoverishment rules,6 presents new data from a 2019 Kaiser Family Foundation (KFF) 50-state survey about state policies and future plans in this area, and considers the implications if Congress does not extend Section 2404.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (15 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101767792 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101767792