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Medicaid

Medicaid Estate Recovery: A 2004 Survey of State Programs and Practices

Research Report

June 2005


To recoup costs of long-term care and other related Medicaid services, Congress mandated in 1993 that states implement programs to recover funds from the estates of certain beneficiaries. In 1996, on behalf of AARP's Public Policy Institute, the American Bar Association’s Commission on Law and Aging surveyed the scope, variation and operation of state Medicaid estate recovery programs. This PPI Issue Paper reports the results of the ABA Commission's 2004 updating and expansion of its original study. The new survey found that:

  • The financial impact of estate recovery on state budgets remains modest but not insignificant.

  • Estate recovery amounts, measured per estate, are modest but not insignificant.

  • The scope of estate recovery efforts is expanding.

  • Estate recovery policies and practices vary significantly among the states.

  • State estate recovery notices vary widely in timing, frequency and clarity.

  • The lack of basic data collection and research impairs assessment of estate recovery efforts.

  • Policymakers have generally not examined the broader public policy issues posed by estate recovery.

While examining the dollars and cents public policy impact, the survey did not seek to answer the human impact questions that arise in connection with estate recovery. These, the authors maintain, are questions that must be answered to determine more realistically whether any of these practices are beneficial, harmful, equitable, good policy, or bad policy on a human scale. (97 pages)

Pub ID: 2005-06