The Imperative of Equality in Long-Term Care
If you need long-term care covered by Medicaid, the state does not treat all applicants equally. I was proud to partner with AARP Connecticut in preparing an Op-Ed, published in the CT Post, on the importance of revising our Medicaid laws:
As we age, long-term care needs threaten the financial stability we aim to achieve. To cover the exorbitant costs of care, many couples turn to Medicaid Title 19. However, Connecticut’s Medicaid laws are long overdue for revision, failing to protect the financial welfare of the spouse who does not need care, referred to as the “community spouse” (who is more often a woman).
Fortunately, the state has an opportunity this legislative session to protect community spouses by supporting the Human Services Committee’s bipartisan effort in Senate Bill 195 (SB 195).
Under current Connecticut law, a community spouse is permitted to keep at least $27,480. This is known as the minimum community spouse protected amount. If the couple’s countable assets exceed $27,480, then the community spouse can keep one-half of the couple’s countable assets, but not more than $137,400. This amount is known as the maximum community spouse protected amount.
The current law disproportionately discriminates against lower- and middle-class families who are not permitted to protect the same amount of assets as upper middle-class families. SB 195 raises the minimum community spouse protected amount from $27,480 to $50,000, propelling the state forward in preventing impoverishment of the community spouse.
Here is an example of the discriminatory impact of the current law, in real life numbers: If a married individual in an upper middle-class family applies for Medicaid with $300,000 of countable assets, the Connecticut Department of Social Services determines the amount that the community spouse is permitted to keep by first dividing the couple’s assets in half. The community spouse is permitted to keep half of the couple’s assets — in this case, $150,000 — capped at the maximum amount of $137,400. Because half of the couple’s assets exceed the maximum allowable amount, the community spouse keeps the maximum amount of $137,400. By comparison, if a married individual in a middle-class family applies for Medicaid with $120,000 of countable assets, the community spouse is permitted to keep half of the couple’s assets — in this case, $60,000. However, if the couple has $50,000, the community spouse is allowed to retain no more than $27,480. SB 195 would allow the couple with $50,000 to retain $50,000.
In these examples, the upper middle-class family receives far greater financial protections than a family of lesser means. Without financial protections in place, families are forced into a mad spending dash, purchasing furniture; renovating the home; purchasing prepaid funerals — in essence, throwing money out the window for the sake of expediting eligibility for vital supports and services. The same vital supports and services that upper middle-class families access with $137,400 of assets safely secured. This money is much better spent keeping the community spouse self-sufficient and in her home for a longer period of time. It’s the difference between independence and dependence; between dignity and despondency.
AARP Connecticut and elder law attorneys across the state endorse SB 195, recognizing that $27,480 is insufficient to prevent impoverishment of the community spouse. The passage of SB 195 is an imperative and fiscally responsible step toward ensuring that the threat of long-term illness is no longer a nail in the coffin of financial stability for the community spouse.
