“Medicaid’s Dark Secret,” by Rachel Corbett, The Atlantic

“‘It’s Medicaid, a low-income program, that has by default turned into our long-term-care system, and that is absolutely unsustainable,’ Matt Salo, the executive director of the National Association of Medicaid Directors, told me. Defenders of estate recovery see it both as a way to control the high costs of long-term care and as a necessary check on those who could pay for such care but would rather the government foot the bill. (Nursing homes cost $89,000 a year, on average, for a semiprivate room.) Medicaid, Salo told me, is already struggling to meet the needs of the poorest Americans. Should it also cover long-term care for ‘someone who’s going to pass hundreds and hundreds of thousands of dollars of assets on to their family?’”

LTC Comment (from Stephen A. Moses, President, Center for Long-Term Care Reform):

Read this deeply biased attack on estate recovery with a grain of salt. In fact, for balance, read these two defenses of estate recovery, both of which I wrote, that helped it become the law of the land in 1993:

Medicaid Estate Recoveries:  National Program Inspection — Office of Inspector General (1988) — Archived permanently here

The Medicaid Estate Recoveries Study–Volume I:  Estate Recoveries in the Medicaid Program — Health Care Financing Administration (1985)

Bottom line, before estate recovery Medicaid became the dominant payer of long-term care and caused the system’s institutional bias, access and quality problems, and on-coming insolvency. Estate recovery gives people a reason to plan ahead for long-term care and stay off Medicaid. For those who don’t plan, it gives families a way to pay for the care they receive instead of suffering the indignity of taking public welfare.