Tom Gialanella, 56, was shocked to find out he qualified for Medicaid
under ObamaCare. The Bothell, Wash., resident had been able to retire
early years ago, owns his home outright in a pricey Seattle suburb and
is living off his investments.
He wanted no part of the government's so-called free health care.
"It's supposed to be a safety net program. It's not supposed to be for
someone who has assets who can pay the bill," he said.
And after reading the fine print, Gialanella had another reason to flee Medicaid -- the potential death debt.
Though many may not realize it, states are allowed to recover the
cost of health care after someone's death by seizing their assets. It
applies to Medicaid recipients who are between the ages of 55 and 64.
The law has been in place since 1993, when Congress realized states were
going broke over rising Medicaid expenses.
But under ObamaCare, Medicaid eligibility has expanded dramatically
along with the promise that the federal government will pick up the cost
of the higher tab -- at least for the first few years, after which
states will be on the hook for a portion of the increase.
Millions more are entering the system, perhaps without knowing that their assets could be at risk.
However, just like Gialanella, others are opting out.
A Washington state couple in their early 60's actually got married
recently so their combined income would keep them out of Medicaid and
allow them to purchase a plan on the health exchange. Filing as
individuals, their incomes had been low enough that they qualified for
Medicaid.
They married primarily because Sophia Prins owns a home and wants to
will it to her children without any worry that the government will
attach a lien for the cost of her medical care. Prins doesn't think it's
fair to go after the assets of people who get government assistance
through Medicaid, but not those getting taxpayer subsidies through the
exchange plans.
The story prompted Washington's Democratic governor, Jay Inslee, to
issue an emergency rule change. It says the state may only recover the
cost of nursing home care provided to Medicaid recipients in that 55-64
age group. That's the minimum allowable under the 1993 law.
"We have this population that we want to make sure they have access
to health care," said state Medicaid Director MaryAnne Lindeblad. "We
want them to get in so they can get the kinds of services that keep them
healthy."
Oregon followed suit. But the 23 other states that expanded Medicaid
under ObamaCare have not changed their estate recovery policies. A lot
of money is at stake.
In 2004, California collected $44.6 million through estate recovery.
It's a number that is certain to rise dramatically. MediCal officials
tell Fox News they expect 1 million-2 million additional enrollees by
2015.
Minnesota, a much smaller state than California, managed to collect
$25 million in 2004. It, too, is keeping its estate recovery policy in
place.
Critics see a money grab.
"I think that people are maybe in for a shock when they find out
their heirs are going to be paying for their care, because they got into
a system under false pretenses," said Dr. Jane Orient of the
Association of American Physicians and Surgeons, a group opposed to the
Affordable Care Act.
The estate recovery law is so under the radar right now that interest
groups like the AARP are still studying how it will play out under
ObamaCare for seniors.