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House Nears Medicaid Spousal Impoverishment Vote

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Members of the U.S. House could vote this week on a bill that includes a Medicaid long-term care (LTC) benefits eligibility provision.

The bill, H.R. 3253, would affect the husbands and wives of people who end up using Medicaid benefits to pay for home care, adult day care services, or other home-based or community-based LTC services.

(Related: House May Pass Medicaid Planning Measure This Week)

House leaders said Monday, on their bill consideration website, that H.R. 3253 could come up on the House floor sometime this week.

The bill could affect  financial professionals who help clients understand Medicaid LTC benefits eligibility rules.

Medicaid Eligibility Rules

Medicaid — a program designed mainly to provide health care services for the poor — uses a combination of state and federal money to help people pay for nursing home care and other forms of LTC services.

People normally need to have assets under a certain level to qualify for Medicaid LTC benefits.

Federal and state rules let married couples keep extra assets, to protect the spouse of someone who needs Medicaid LTC benefits from becoming poor.

Medicaid has separate spousal impoverishment rules for Medicaid nursing home benefits and for Medicaid benefits for home- and community-based care.

Long-term authorization for the spousal impoverishment rules for Medicaid home- and community-based care benefits have expired. Congress has been using a series of short-term extensions to keep the current rules in place. In April, President Donald Trump signed a bill, H.R. 1839, that extended the spousal impoverishment rules expiration date to Sept. 30, 2019, from March 31, 2019.

H.R. 3253

Section 4 of H.R. 3253 would keep the current spousal impoverishment rules in place until March 31, 2024.

Rep. Debbie Dingell, D-Mich., is the bill’s lead sponsor.

Dingell is the widow of John Dingell Jr., a Democrat who represented Michigan in the U.S. House for 59 years. She has pointed out that she was her husband’s caregiver.

House leaders have put H.R. 3253 on their “suspension calendar.”

House leaders use the suspension calendar to speed up consideration of bills that appear to have strong, bipartisan support and seem likely to pass with little opposition.


A copy of H.R. 3253 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.

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