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Tracking Health Reform Lots of Pain for Little Gain: Three Decades of Medicaid Estate Recovery

delete2026-02-01
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PRE
AI
A
Amanda Spishak-Thomas *
E
Emma Sandoe
H
Heather Howard
DOI:10.1215/03616878-12166749delete
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Abstract

Abstract

En 中文
Since Congress enacted Medicaid estate recovery into law in 1993, there have been few changes to the policy and little research to investigate its effectiveness. Under Medicaid estate recovery-a response to the rising and uncertain costs associated with long-term custodial care among a rapidly aging American population-states have the right to track former Medicaid beneficiaries' assets and seek recovery from their estate after their death. Although it makes an insignificant dent in state budgets, Medicaid estate recovery can nonetheless have a lasting impact on the lives of families subject to its repayment requirements. For low-income families where homeownership is their primary source of wealth, policies aimed at homeowners may exacerbate longstanding disparities in wealth and disproportionately burden Black and Hispanic families. Recently, some states have initiated policy changes to address problems with Medicaid estate recovery, and similar legislation has also been introduced in Congress. Such reforms, if more widely adopted, may improve the financial circumstances of surviving family members of deceased Medicaid beneficiaries.
Keywords:
Medicaid
Medicaid estate recovery
long-term care
financing
disparities

Journal

J
Journal of Health Politics Policy and Law
IF:
2.8
Papers:
2.5K
Citations:
1.4K

Organization

R
rutgers university system
Scholars:
4.1W
Papers: 3.6W
Citations: 53
R
Rutgers University New Brunswick
Scholars:
667
Papers: 442
Citations: 0
P
princeton university
Scholars:
2.7K
Papers: 1.4K
Citations: 0
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