Expanded Medicaid’s fine print holds surprise: ‘payback’ from estate after death
|By Carol M. Ostrom, The Seattle Times|
|McClatchy-Tribune Information Services|
It was the fine print.
As fine print is wont to do, it had buried itself in a long form -- Balhorn's application for free health insurance through the expanded state
She was shocked: If you're 55 or over,
The way Prins saw it, that meant health insurance via
With an estimated 223,000 adults seeking health insurance headed toward
The federal Affordable Care Act (ACA) changed that. Now many more low-income residents will qualify for
But if they qualify for
Prins, an artist, and Balhorn, a retired fisherman-turned-tango instructor, separately qualified for health insurance through
But if they were married, they calculated, they could "just squeak by" with enough income to qualify for a subsidized health plan -- and avoid any encumbrance on the home they hope to leave to Prins' two sons.
"We're happy to be getting married," Prins said last week. "Unfortunately not everyone has such an elegant solution to the problem."
Over the past month, as lawmakers began hearing from worried and angry constituents, state officials began exploring what it would take to fix this collision of state rules with the ACA.
Late Friday, Gov.
They hope to be able to change the rules before coverage begins
Fixing the problem will cost the state about
"There was no intent on the part of the ACA to do estate recovery on people going into
People in their 50s and 60s make up about 30 percent of the adults who have signed up for health insurance through
Some 55- to 64-year-olds, who may have taken early retirement or who were laid off during the recession, have found themselves plunged into a low-income bracket. Unlike
For health coverage through
At first, Prins was pleased at the prospect of free coverage.
But the more she thought about the fine print, the more upset she got. Why was this provision only for people age 55 and older? Why should those insured by
As Prins began searching for answers, she found that even those trained to help people sign up for insurance under the ACA weren't aware of this provision, nor were some government officials.
Around the country, the issue has sizzled away in blogs and commentaries from both right and left.
"People will think this is wonderful, this is free insurance," Orient said in an interview. "They don't realize it's really a loan, and is secured by any property they have."
Even states that are now limiting estate recovery, she warned, can change the rules again if budget problems become more intense.
One reason this snafu has become so troublesome is that ACA rules appear to give those who qualify for
People cannot receive a tax credit to subsidize their purchase of a private health plan if their income qualifies them for
But they could buy a health plan without a tax credit, she added.
For someone age 55 to 64 at the
Ball in states' court
It's not the first time federal and state rules have clashed, and local officials now find themselves on the hook to ensure that the new law doesn't create hardship.
Recovery will no longer apply to health benefits for those 55 and over, the
On Friday, Washington Medicaid Director
As for Prins and Balhorn, they're good with their choice.
Instead of paying
Sunday, they made a big fruit salad, dressed in tango clothing and were married in their home. Afterward, they danced to their favorite tango music and toasted each other with orange juice and a dash of cranberry.
"I'd be very happy if the governor actually makes this change possible," Prins said late last week. "And I'm very happy to be getting married!"
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