California Gov. Jerry Brown, D, has vetoed a bill that would have affected estate planning for some married couples and might have affected couples’ interest in private long-term care insurance (LTCI).
The bill, state Senate Bill 1124, would have helped California residents who use Medicaid to pay for care.
California now lets the state’s Medicaid program — Medi-Cal — do what it can to bill the estates of enrollees who die for money spent on Medi-Cal benefits. Medi-Cal can also try to recover from those enrollees’ spouses. The state requires Medi-Cal to waive claims against a surviving spouse if it finds that enforcing a claim would cause substantial hardship to other dependents, heirs or survivors.
State legislative analysts reported that Medi-Cal spent about $56 billion in 2012-2013 and recovered only about $59 million through the estate recovery program.
S.B. 1124 would have limited Medi-Cal to making the estate recovery efforts that federal law requires it to make. The bill would have let Medi-Cal continue to try to recover money spent on Medicaid benefits from the assets of dead enrollees who used Medicaid to pay for nursing home services. The bill would have forbidden the state from trying to recover from the assets of dead enrollees who had used Medi-Cal to pay for acute health care services.
The bill also would have eliminated estate recovery against the estate of a surviving spouse of a dead Medi-Cal enrollee after the surviving spouse died. It’s possible that this provision could have affected Medi-Cal efforts to collect long-term care expenses from the estate of a surviving spouse.
The bill was introduced by state Sen. Ed Hernandez, D-West Covina, Calif.
Supporters, including Consumers Union, argued that the state recovers little money from the estates of Medicaid enrollees, and that changing the law would eliminate a major barrier to enrolling older California homeowners in Medicaid. Today, supporters said, some older, low-income adults fear that signing up for Medicaid could lead to the loss of a home.
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The California Department of Finance argued that changing the rules could eliminate a source of cash used to pay for care for other Medi-Cal enrollees.
Brown said in a veto message that providing more estate protection for Medi-Cal enrollees might be a reasonable policy goal.
“The cost of this change, however, needs to be considered alongside other worthwhile policy changes in the budget process next year,” Brown said.