Members of the U.S. House could vote this week on H.R. 259, a bipartisan bill that includes a provision that could affect long-term care (LTC) planners.
The bill would keep a Medicaid home-based and community-based LTC program alive. The bill would also let states extend efforts to keep a couple’s use of Medicaid home and community-based LTC programs from eating up all of the income and assets of the care recipient’s spouse.
The new Democratic leaders of the House have put H.R. 259 on their “suspension calendar,” or list of bills that can be passed quickly, without a recorded vote. In the past, the House has voted on most suspension calendar items on Mondays, Tuesdays and Wednesdays, according to the Congressional Institute.
Rep. Frank Pallone Jr. is the bill’s sponsor.
Rep. Greg Walden, R-Ore., is the bill cosponsor.
The House convened at 2 p.m. Eastern time today and then took a break that’s set to end at 4 p.m., according to the House live video feed. The House could start voting on suspension calendar bills around 6:30 p.m. today, according to the website of House Majority Leader Steny Hoyer.
H.R. 259 Details
Medicaid uses a combination of federal and state money to pay for health care for the poor, and for nursing home care for people who meet state and federal eligibility requirements.
H.R. 259, the “Medicaid Extenders Act of 2019″ bill, would continue the Medicaid Money Follows the Person Rebalancing demonstration program.
The Medicaid Money Follows the Person program encourages states to experiment with using Medicaid nursing home benefits money on services that can keep elderly people and people with disabilities in their own homes. States can use the program to pay for programs such as home health aide services, personal care services, homemaker services, information services and adult daycare services.
H.R. 259 would provide $112 million in funding for the program for fiscal year 2019.
Federal fiscal year 2019 started Oct. 1.
A provision in the Patient Protection and Affordable Care Act (PPACA) requires a state to apply its Medicaid “spousal impoverishment” rules when deciding whether an individual is eligible for Medicaid-LTC services.
That provision was set to begin Jan. 1, 2014, and end Jan. 1, 2019.
H.R. 259 would extend the spousal impoverishment protection period until March 31, 2019.
H.R. 259 is similar to a provision in H.R. 7217, a bill introduced by Rep. Joe Barton, R-Texas, in December.
H.R. 7217 passed in the House by a 400-11 vote Dec. 11. The Senate received the bill but never acted on it.
The Medicaid Planning Debate
Many lawyers help clients structure their assets in such a way that those clients can keep assets, or at least keep assets in the hands of loved ones, if the client or a client’s spouse ends up needing Medicaid LTC benefits.
Many policymakers are particularly eager to keep LTC benefits eligibility and contribution requirements from pushing the spouses of the care recipients into poverty.
Over the years, some health policymakers, and some private LTC planners, have argued that overly generous Medicaid planning provisions can backfire, by encouraging middle-income and upper-income people who could afford to use private insurance and private savings to pay for their own LTC services to rely instead on Medicaid LTC benefits.
A Flu Bill
House leaders have also put the Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2019″ bill on the suspension calendar.
That bill, which does not yet have a bill number, would reauthorize and update programs designed to protect the country against severe influenza epidemics, antibiotic-resistant bacteria, biological warfare, and other catastrophic risks related to infectious diseases.
A copy of H.R. 259 is available here.
A publication giving the views of critics of broad Medicaid spousal impoverishment prevention provisions is available here.
A Congressional Institute discussion of congressional suspension calendar rules is available here.
A copy of the pandemic risk act bill is available here.
When the House is in session, live video of floor proceedings is available here.
— Read 3 Insurance-Based Medicaid Planning Strategies, on ThinkAdvisor.