• Bye-Bye Medicaid Asset Test*

    The Affordable Care Act (ACA) goes a long way toward simplifying Medicaid eligibility. Go try and figure it out from the legislative language and you’re not likely to believe me. Fortunately, Joy Johnson Wilson, Health Policy Director for the National Conference of State Legislatures, has done the dirty work. In a handy document Wilson summarizes Medicaid and CHIP provisions in the new law and compares them to current law.

    In particular, on page 8 Wilson notes that the ACA “[r]equires states to use a net income standard (no asset or resource test, no income disregards) to determine [Medicaid] eligibility.” Yep, you read that right, bye-bye asset test. Hello simple income test. The new federal income eligibility threshold will be 133% of the federal poverty level (effective 1/1/14).

    Essentially, the Medicaid expansion under the ACA will broaden Medicaid eligibility for low-income, non-elderly adults without regard to assets. A major exception for that age group are those with incomes above the threshold but with high out-of-pocket medical costs. Such individuals will be required to spend their assets down to the existing asset limit, which varies by state and is typically a few thousand dollars.

    There are a few other caveats. Existing rules, including the asset tests, will continue to apply for individuals obtaining Medicaid eligibility through another program (e.g. foster care children, or SSI/SSDI recipients) and the elderly.

    Medicaid qualification just got a whole lot easier (or, rather, it will in 2014).

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    • My jaw just hit the floor.

      I don’t understand the idea behind elimination of asset tests for assistance programs. Increasing allowable assets may make sense if your goal is to expand access, but eliminating it means that people who could afford to pay a reasonable premium don’t have to.

      The same problem exists with food stamps in New York, where it seems as though the asset test was eliminated in 2008. I haven’t been able to find anything explaining that decision either.

    • In response to Jay, we can assume that the great majority of people who earn less than 133% of poverty won’t have sufficient assets to support themselves. My wife and I were at about 133% of poverty and we DO have a significant amount of liquid assets, because of a settlement I was given from an auto accident. That’s definitely a rare case, though. And verification of assets is definitely an administrative hassle.

      • There are alot of people who claim to be under the 133% of the poverty level but work under the table or have additional cash paying jobs, These individuals can afford premiums but its just another loop hole this plan will create for people to take advantage of. There should always be a checks and balance for every program … it should never be to easy to get government provided benefits. Haven’t we learned our lesson with the welfare system and how many people take advantage of that every day.

      • I now qualify for Medicaid and I do not want it! I own a 2000 sq foot ranch style well-maintained home in a beautiful neighborhood. It’s free and clear. My husband died two years ago and I’m 61 and living off of investments that are dwindling but nevertheless, I am comfortable. I am looking for work which I quit to care for my husband. I have two vehicles, include a 2006 F250. I live in the country and I have acreage. I can’t afford the 900 insurance premiums I had or my investments disappear too fast. I have zero health problems. I really wanted to be on the exchange and have a discount so I could pay. Instead, they want me to be on Medicaid and have estate recovery applied to my home and more. This is terrible! So I will continue without health insurance. Wonderful.

        • I think if you plan on making $16,000 ($15415 to be exact, Colorado) or more in the year 2014, you can still get health insurance under the affordable care act (ACA) instead of getting Medicaid. I do not know if this amount is the same in every state. Maybe you should plan on making $16,000 next year! I do not know what happens if you don’t make it and so actually did qualify for Medicaid but took the ACA insurance instead, law-wise. I am not a lawyer, but an insurance agent might be able to help you out here. Good luck!

        • if you want to have insurance instead of medicaid, and you have stocks you can sell some of the stocks in january of 2014 to increase your income out of the medicaid range.

          • @Dennis — Sale of stock does not work. The sale is coming from a ROTH IRA. It does not count as earned income. What one needs is earned income to avoid Medicaid — proceeds from sales of assets or withdrawals from Roth IRA are not counted toward earned income. I asked the state of WA. Their response was that I could choose among: Medicaid & asset recovery; no insurance/penalty; 800-902 premium for private. Finding a position at 61 is not easy, I am discovering. I have an excellent resume. It’s poopy.

            • the subsidies under the health care reform law, is figured on modified adjusted gross income, for most people modified adjusted gross income is form 1040, line 37 + line 8b + 20a – 20b using 2012 form

            • if you well be 62 in 2014 ss benefits may increase your income out of the medicaid range.

    • a millionaire could be on medicaid and contribution to a ira could make a person quailify for medicaid

    • I own three houses and currently have no income. I have an occasional opportunity to work cash under the table for$10.00per hour. I have three college degrees. I couldn’ find work in Puna so I came to look for work in California i spend most of each day seeking employment. The local porn store has a help wanted sign in the window. So far that is the only place I’ve skipped applying at. The only problem is that there is nothing free. What one person gets free another person pays for and that’s shitty. But I’ll take the’m’m Medicaid because i have no insurance nd
      and I’m loosing my eyesight fast and would rather keep my eyesight than go on disability. I don’t want to sell my house s

    • Yes, Dennis, you are correct. There’s a man over on Maui who owns his house, worth over $1,000,000 were he to sell. He has no taxable income and rumor on the Big Island is he gets food stamps and will qualify for Obamacare. This elusive man has no name that I’ve heard but that’s the story.

    • I’m 60 years old, retired, with no pension and with 900,000 in assets earning on average 1.4%. So, with my income of 13,000 (family of 1) I’ll qualify for Medicaid??? No asset test??? Really???

    • If I have significant assets, earn under the federal poverty level, and apply now (AZ) will I be denied? Should I wait until 2014 to apply? Is their any reason to withhold any asset information on the application?

      • they dont ask about assets on application . if your 2013 income is less 100% of fpl but think your 2014 well be over 100% of fpl you should apply in 2013

    • Plenty of people with assets of over a million dollars will qualify if they have no “earned income” which lets face it most millionaires don’t. With no asset test they could have a million dollar home, a million dollar yacht,, and a multi-million dollar investment portfolio that is increasing in value every year and qualify as long as they don’t earn enough dividends or sell enough shares paying to put them over the income limit they would qualify.

      • Hey Trevor, you are mostly right but the income test will use Modified Adjusted Gross Income (MAGI) which will include earned income, unearned income (interest and dividends) and also non-taxable income (tax-free interest, etc).

    • Presumably, they are trying to protect the between jobs person scrounging a living on temp work, part time work or freelancing. They don’t want the person to be financially wiped out because that is likely to destroy his ability to stay off public assistance. Presumably, they feel such a person is drawing down his savings anyway and they want to make sure that he doesn’t wind up on welfare for the rest of his life.

    • Hi, I am an older citizen with a small savings account and I
      am starting a small business. My income is near the threshold
      limit; if I wipe out my savings account who is going to pay
      for unexpected emergencies??

    • Yes, think of it. Our government would be paying for health care for US citizens that have low incomes. The folks that have assets have earned them and our government should not be in the business of picking and choosing who has government funded health care. Every citizen should be able to get Medicaid. The middle and upper class should also be able able to get Medicaid. The private insurance companies would insure anyone who did not want to be covered under Medicaid. Who would pay for the expanded Medicaid programs? The wall st. Companies and oil companies and high wage earners. The U.S. has a long way to go when it comes to health care reform. The ACA is a good start. There are people sick and dying today without health care. Let’s be a country that takes care of each other.

      • @ Jane — I do not and will not take Medicaid because of asset lien/recovery which kicks in at age 55. In addition, few specialists and few doctors here take Medicaid. I am not poor. I have assets but not earned income. I have a free-and-clear home; two paid off vehicles and more.. No debt.. I have a ROTH I am living off of. But I cannot afford/will not afford a 900 premium that results in me having to still pay doctor bills out-of-pocket as deductible is high/not met. I wanted/hoped to be on the exchange. But I do no have that option. Figure I’ll hang on onto Medicare four years from now… or see if I can find work that pays 16K.

    • My husband & I will both be on Medicare shortly. Our income will be as follows: $952.40 husbands SS
      129.00 VA disability- husband
      601.30 wife SS
      ———–
      Total $16872.70
      Less 104.90 Part B Medicare (wife)
      ————–
      $1577.80
      My question is, will I (wife) be able to also receive Medicaid? & am I responsible for husbands assets…. cars? He feels that it is wrong to require an individual to divest someone of things that they have taken a lifetime to aquire.
      His medical is taken care of by VA but I do not, nor have had any medical coverage. If this is the case, I foresee that this will still be the case.

      • I can only speak for Washington state but here, Cheryl, those autos do not matter in value as there is no asset test. However, here in Washington state, they maintain an account that keeps a record of your medical expenses and the Medicaid expenditures. Multiple scenarios can trigger the state to begin the asset recovery process. Also there are exceptions. If a husband on Medicaid dies, for example, while the wife is living in the home, recovery is delayed. You need to check to learn what the asset recovery process is in your state. Some states are far more lenient than Washington state.

    • Fine… I had no option but be told by Covered California, California’s Marketplace website that MediCAL is my only option.

      The tricky parts of the whole situation are;
      They do not have a way to fill out application for MediCAL through CC site.
      .ALSO, from all I am reading, if we do NOT have submission and approval by Jan 1 2014 ( some say Dec 15th 2013)..we will be assessed the penalty even though the marketplace runs into March, BUT, here’s the big part…They keep stating that the elimination of asset test is not effective until Jan 1 2.014. So, let me get this straight…to have the no asset test for qualification we must wait until Jan 1 2014 to apply under the new rules, but if it is not EFFECTIVE by same date…we will be administered the $95 penalty…..Seems like a unusual way to handle low income peoples needs.
      Good Luck on being able to find any definitive information or clarification on this…You can not get through to MediCAL unless you are already enrolled and Covered California doesn’t seem to KNOW….SIGH

      • December 15 is the deadline for having coverage effective January 1. You don’t need to have coverage by the first of the year to avoid the penalty.

        The earliest the enrollment deadline for avoiding the penalty would be is February 15 (see here). That said, the administration is seeking to extend that to March 31 (to correspond with the end of open enrollment—see here).

        • OK…have gotten way farther on submission for Insurance…Only option for me is Medi-CAL due to income level. So, when I was locked out of Covered California market system…I went to HHS.gov…was relayed to Local Human Services Dept. but couldn’t hear anything. I tracked down office and called myself,.. directly. I was put through wasted time with 3 people and then was forwarded to an agent, where I very plainly stated that I was applying for NEW ACA Medi-Cal to be in effect Jan1st.2014. .I was told a written application was required and it would be mailed to me. An application was mailed, but it was the 20 page application for current process and people applying…Again frustrated…I called back and went to original contact, who then hooked me up with a Lead Agent. We had to do App. by hand as Fed system was down, Which happens all the time. Questions that were NOT required for NEW ACA MEDICAL App. were asked and I simply replied that the asset questions were not required…Only Name, Address, SS#, and AGI Income from 2012..ANNE–.this is a key answer for some questions here..There is no guessing 2013 or 2014 income….it goes by your last Federal Tax AGI, so that it can be verified by Federal system. When it is verified it is stated that you have PINGED…The lead that I worked with said they would call when I pinged and would let me know if anything further needed to be done. I did not hear from that person, specifically, but the Supervisor called me 4 days later and informed me that I needed Residency Verification…I couldn’t help it…I busted out laughing and asked how did they think I received mail from them if I wasn’t a resident and said DMV is in same building and that would be easy to verify. I was told all Applicants would have to submit copy of Drivers License ( They must have a need for Photo IDs on all the people…MUST have PAPERS), I asked for a letter of request,, so that I would have a paper trail, reply was it would be mailed in one day….I waited patiently, but as of yesterday, NOv. 13, I called back, because I did not receive the letter. I asked for the lead I worked with, but they were out to lunch (no pun intended), the agent who answered said she would try to help…let me make this part short…I wasted 45 minutes with someone who did not have access to verification system, nor did they understand anything I was telling them, finally at 1 hour…I said to go see if the lead was back from lunch….they did, and asked for phone number so that I could be called back. 10 minutes later call came in…I updated that I did not receive letter…they traced, no answer, but resending letter, as of now and I have 10 days to respond..( My mind is already saying…they used my physical address, not mailing address)…10 minutes later, my mind was verified as I got a call stating exactly that…wrong address was used…new letter going out and reply deadline extended additional 3 days. I was also informed that I pinged on all submitted information and given my Case number and Application Number. Was also told I could go on Covered California and see the information submitted and the status currently, but I’ll be (darned) if I could find where that particular section was…SO, if you are pushed to Medic-Aid, or a State Medical system…GO DIRECTLY to your Local Social Services Office and you will get processed far more efficiently..well, compared to other systems. Yes, I started Oct 1st, but that was all research and getting answers. My actual process started Oct 24th and the final step is within sight nearly a month later…if not I will report back

    • if you estimate your 2014 well be over medicaid range, but it is in the medicaid range at end of 2014. no problem that is ok, don’t know what happen if you sign up for medicaid, and income increases out of the medicaid range in 2014,

      • @Dennis — Hmmm… I thought it was the income for 2013 that you report on your 2014 IRS taxes…. are you sure?

        • under the health care law, well use estimated 2014 modified adjusted gross income. if you are going convert money from traditional ira to roth or sell stocks in a taxable account, well need to wait untill 2014 . for the income to be taxable in 2014, if you want to get your income out of the medicaid income range. or over 100% of federal poverty level if you live in state that is not expanding medicaid, modified adjust gross income well need to be out of medicaid range or over 100% of fpl each year until age 65.

        • when you purchase insurance you well need to estimate your 2014 income , which well the income that you well report by april 15, 2015

    • nw-woman-
      I have looked over this same problem- it is extremely inequitable that only low income people ages 55-65 have to repay all their new Medicaid expenses (especially when higher incomes get subsided healthcare & do not have to repay it ever!!), and only in some states… Estate recovery is a federal lawrequired for long term care recovery, but leaves any additional recovery open to state law. You need to check the fine print on your state’s health care application (it’s the same application for both Medicaid & subsidized healthcare). It’s usually in the Rights & Responsibilities section. Of the 26 states currently expanding Medicaid, I have been able to confirm that the states of CO, MA, MN, NY, OR, RI & WA include “Estate Recovery” clauses for those 55+ and on the new Medicaid). Are you in one of these states?

      Ironically, those 11 states using the federal website (and using expanded Medicaid) do NOT have estate recovery on their applications!! As well, CA, DC, MD NM & VT do NOT include estate recovery. (yet to confirm CT, HI NV- does anyone live in these states & have access to their application?).

      Anyway- Yes, the actual 2014 income is what will be used at “reconciliation time” (when you file your 2014 tax forms on April 15, 2015, after receiving healthcare in 2014). Your 2012 & 2013 incomes are just used as a guide to get people on the right track for Medicaid or subsidized plans. You are allowed to tell them whatever you think your income will be in 2014 and they HAVE TO base their decision on that (especially if you tell them that your income will be higher in 2014 than 2012 for example, they cannot give people “free” Medicaid” when you both know you would have to repay the premiums at reconciliation time). ALL of the income listed on page 1 of IRS form 1040 is counted- they actually use line 37 “adjusted gross income”, plus a couple of other types of untaxed income (foreign income, etc). So, if you project that you will be self-employed in 2014, have capital gains, etc. for example, then you can project your 2014 income that puts you above the Medicaid/Estate Recovery trap. I imagine there will be lots of people “estimating” that they will be taking distributions out of their IRA’s (taxable income- it counts), in order to keep their 2014 income in the subsided level (rather than at the Medicaid/estate recovery trap level).

      If this is not possible, there are other options that are listed in this memo about Estate Recovery from www. washingtonlawhelp.org.

      http://www.washingtonlawhelp.org/resource/estate-recovery-for-medical-services-paid-for

      • @48 North —

        I am way ahead of you although I thank you for your detailed post. I live in Washington state and am a widow. Yes, Washington state applies asset recovery to every single expense associated with any medical care provided via Medicaid, not simply long-term care.

        I certainly don’t consider myself low-income. My “problem” is that my income source is direct withdrawals from my savings/investments and that I have no debt and no wage income. The problem is further complicated by private individual premiums that are sky high and only provide insurance — not payment of the doctor bills.

        I should not qualify for Medicaid. If the asset test was still in effect, I would not qualify.

        And IRAS are taxable income depending on the type of IRA — Roth versus Traditional.

        I talked to my CPA yesterday who told me that I should go ahead and simply plug a figure into the Washington State health exchange and then we will work on how to do withdrawals and other income shifts to assure that I “look” like I have the required base earned income.

        But this is ridiculous. And the people really that are most affected are entrepreneurs — as they are the one’s who are in the private health care market for the most part.

        • did you cpa tell you , you could convert money from a traditional ira to roth to claim the subsidies instead if going on medicaid, or sell stocks, ???????

        • 100% of federal poverty level is 11490.00 but that figure well be adjusted for inflation in january 2014, if want your income out of the medicaid you well to enter number more than 11490.00*1.38* =15856.20 well need to enter a number more than 16000.00 because of inflation.

          • I tried that…But since they are verifying it by the 1040′s filed in 2012…it didn’t work…They don’t fall for the “estimated increase” of income ploy.

      • Go here then read the associated articles:

        http://www.dailykos.com/story/2013/10/21/1249471/-Estate-Recovery-It-s-Worse-Than-You-Thought

        I’m 59 with a small pension but with not-insignificant assets. I qualify for Medicaid and created an account on the Marketplace. I’m stalled until they correct my eligibility (CHIP, haha) and, um, review ?) the several copies of my Green Card they keep asking for. Just found about estate recovery and it scares me to death. My predicted income will be exactly 139% of FPL in 2014.

        I predict it will be open-season once the States reread that law and grasp the implications.

        I’m Canadian-born and have had one foot aimed at the Detroit/Windsor tunnel for three years now. Jeez, what next?

        • Sorry, forgot to mention the link has the list of States that go beyond long-term-care-only recovery.

          Be afraid. Very afraid, you in those states…

      • I am self employed and will adjust my business cost accordingly. If I need to spend less on business expenses in order to avoid medicaid and buy my own plan I will.

    • what well happen if a person qualifies for medicaid, based on 2013 income but their 2014 income increases out of the medicaid range??????? may not know their 2014 income is out of medicaid range until april 15, 2015 … same issue if a person’s income increases from less than 100% to more 100% of fpl in states that are not expanding medicaid.

      • Dennis, If you get a refund you have 30 days from the date of deposit to spend it in most states. However, if people get Federal Earned income credit you have up to a year to spend it, some states could very, I read one that said six months. They will want proof you spent it. State Earned income credit varies by state. Any time you get a one time payment, sell an expensive item or insurance you usually have 30 days from the date of deposit to spend it-you might be able to extend it with permission for the local office, like if you are expecting medical bills. If your house get destroyed they would most likely would give you more time than 30 days from the date of deposit. They don’t care what you spend the money for, as long as it is spent down to the what you are allowed to have in your checking. We are allowed $1,500 per person. We never have that in their unless we get one time payment.

    • We are in California an we made a great deal of money in 2012 and retired early, 59 for my spouse and 60 for me. We have a nice amount of assets. We are living off money in a bank account and selling stock as needed. Our 2013 taxable income will be only $30,000.00 and a bit more in 2014. We understand that we can deduct long term care insurance premiums over 10% of our income for 2013 but not health care premiums. It looks like we will qualify for a sizable subsidy for next year. Is that the way you also interpret it? What happens if we sell even more stock next year that realized more gains than expected? Do we pay the subsidy back taxes in April 2015. Are we penalized with additional fees, etc.? When we submit our application we have to include documentation of 2012 taxes which were sky high because of the large income for 1 year. Will this disqualify us?

      • everything is based on 2014 mod adjusted gross, 1040 line 37 +8b+20b-20a you shouldnt buy plan that has cost sharing subsidies if you plan on sell stocks

    • We are having difficulty figuring out the Ca Care. Both my husband and I are currently unemplowed. We pay a fortune for Cobra. Cobra ends in 2 months. We were thrilled to think we could get similar insurance to our Cobra for half the price. But the fact that our income was less than poverty level for 2013 puts us in the Medi Cal bracket. Obviously, we have been living off our savings.Should we assume we will find work and make an estimate for 2014? We have assets and home but see our savings dwindling through unemployment and 2 kids in college.
      If we use our low income for 2013 and have to go to Medi Cal and then we both get good jobs in March and go off Medi Cal will we have to pay for those three months we had it?
      Or do we just make an estimate of income we may make and sign up for one of those programs?

      • to::::: ann”:::::: it would better to buy insurance and income be in medicaid range, that to sign up for medicaid and income increase out of the medicaid range. the law doesnt state want happens if a person sign up medicaid and their income increases out of the medicaid range. but if estimate income to be out of the medicaid range and income is in the medicaid range you can still qualify for the premium credit. if person lives in state not expand medicaid , and income increase above 100% of the fpl cant claim subsidies reactivitly , but if income is over 100% of fpl and decreases below 100% of fpl , you can still claim the premium credit. irs bulliten june 11, 2012 T.D. 9590

        • If you are signed to Medic-Cal and your income increases , you have 3 months to buy a new policy off the marketplace…it is in the addendums that a local Social Services office will explain to you.

    • Ok, I still do not understand the whole ” by-by asset test” . Where can I find the guide lines and which is it? I will be 65 soon, so is that elderly asset required, or asset not required? Have been trying to find any documentation to explain. I am not very proficient with navigating on a computer. Much prefer dealing with people. All I seem to find is “page ” upon “page” to click on & none of them answer the questions I am looking for. I am in CO.

      • Cheryl….if you are below 16,k in income…that is Medi-Cal. range.the Asset test we keep mentioning was for Regular Medical PRE 2014…which states that one can not have any assets, including House, car and other items that value over $2,000.00…With ACA that is gone.
        They are speaking of raising the MedicAid-Medi-CAL level to 22, 000 to be eligible…that will flood the system.
        How much longer until you are 65 and eligible for Medicare?
        Might as well go for MediCal…and this whole pay back thing…is MOOT under ACA.ALL of the Medical AID programs are completely paid by Federal now and no repayment is stipulated under ACA
        .If you are on ACA Medic-Aid or Medi-CAL and your income increases out of current range…You then are offered a chance to purchase a subsidized plan by Fed

        • Kira — Better make sure your facts are accurate. The asset recovery is still well and alive here in Washington state for anyone over the age of 55, I believe it is, or 50.. can’t recall which and no time to look up. And it’s not asset recovery just for long-term care here..it’s for any and all medical. I cannot speak for other states but that’s the case here. I even had contact with our legislators about it…. I’m living off of my investments and am certainly not poor but do qualify for Medicaid now..

          • I do check my facts…and when I give a scenario ..it pertains to my conditions and State of California…Each State will have it’s own systems…I just give examples of what I am dealing with…then it’s up to each person to do their own research pertinent to themselves.

    • husband is over 65 and wife is under 65 , how well they figure wife’s subsidy sense they file joint tax return????

    • Kira B: Isn’t Medi- CAL a Cailfornia Medicaid? I live in Colorado. We do not have any investments, stocks, bonds, annuities or savings.. Just our home ( paid for) which since it is our primary ( and only ) home is exempt.
      However, husband has multiple vehicles that he has collected over the years & it is my understanding that we are only allowed 1 vehicle.

      One of his autos is the 1954 Packard that was his fathers & he learned to drive with.
      Our total income will be $16872.70 per month. That is my & his SS plus his VA disability of $129.00. I believe it falls within the 133%, but am wondering about the vehicle question of assets.
      Husband feel ( rightly) that he/we should not be penalized for things that it has taken him a lifetime to aquire..
      Husbands medical is 100% covered by VA but I have no medical ins. I will be going on Medicare in a few months but that is a chunk of $104.90 a month that they will take out of my SS & that I will have to pay out of pocket till SS kicks in. I/we would qualify for Medicaid except for the excess assets.. ie: vehicles.

      I am trying to figure out how we will get by. $1672.70
      -104.70
      ________
      $1568.00
      plus I will have to purchase a part D Rx and as you can see cannot afford to purchase a supplemental ins to cover the 20% that Medicare does not cover. Also will not qualify for SNAP or LEAP due to vehicles as I see it. Hope I am wrong .

      Does anyone have any thoughts on the matter? I would appreciate any and all helpful comments.

      • CheryI, I live in Colorado also, and our state along with some of the others will have an expanded Medicaid program starting on January 1. The Expanded program does not take into account your assets, Only your income. You could have a million dollars in the bank and as long as you were makinga very low or no interest rate and your total income is under the threshold, YOU WOULD QUALIFY FOR MEDICAID! This seems insane, and I have not made it through the whole process yet, but because I do not want the state of Colorado to come after my estate for repayment of whatever amount of Medicaid premiums they determine they paid for me on my behalf, I will try very hard to keep from having to go on Medicaid. I plan on consulting with an insurance agent for help. Anyone have any corrections to my comments? I would love to learn that I am wrong here.

        • Colleen — That’s the same situation here in Washington state. I got deeply into this because I am a widow and I started a new S-corp after my husband’s death. During the start-up stage, I am living off of savings. Home is paid for. No long-term or short-term debt. I was hoping to be on the exchange and to pay a reduced premium during start-up period. If not, health insurance premiums for me are in the $900 range, which is why I cancelled my insurance two months ago. Now I learn that they’ll push me into Medicaid which I am refusing. I’m in a rural area so doctor selection is slim. This is a wheat-growing area with rich farmers. Doctors have been dropping acceptance of Medicaid coverage and the doctor I did find is some 80 miles away. In the snow, that’s too far. I can afford health insurance premiums if I was on the exchange. But I’m not going to have my asets liened because of this so it appears that I will go without health insurance.

          This is great way to treat small business owners, particularly when this country needs more small business activity.

          • I believe there is a need for health care change but they are going about it all wrong. I would have loved to have been able to work more and get a job that lead me to a career but was prevented from it. I am so glad this is all coming to light! I had 2 disabled children and complying with government regulations in order to get medical coverage sucked! That was 30 years ago. It was like selling my soul to the devil. I had to wait 18 years to earn an income and contribute to society. At age 40 I went full speed ahead and went to school got a degree and began working. Unfortunately the economy took a nose dive and I am again struggling to get by. But at least I can look forward to plugging along without the establishment controlling me at every turn. I have always been aware of the assets grab by the state for medicaid recipients. Even though it was my children who were on SSI I am still responsible for the debt.

      • I know I use the MEDICAL quite often, because I am relaying what I am dealing with in California…each of you have to do research on the standards and limitations of your own State and Counties. I gave the number of income for CA….what is your States Poverty level…and is CO doing a State Healthcare system to meet ACA rulings…not all states are. IF you are not in a state that currently has gone this route, then you should be able to qualify for Subsidy Insurance coverage, through the Federal Marketplace, to hold over until you reach Medicare qualifying. From what I have seen the subsidies are quite lower than most premiums and I did not see an asset test for Subsidy. Check on Inheritance assets, as to whether they must be considered when going for any Medic AID assistance…You are, at this point, over the qualifying income for Medical assistance by CALI numbers…. I do not know your Numbers.
        I have seen that their is the option for those on Medicare to use the marketplace to shop for a supplemental plan to add to Medicare…by Dec7, (as is the yearly open season enrollment deadline)…by that standard…You may be able to get a subsidized policy for yourself, which could be rolled over to a supplemental plan when on Medicare..these options need to be researched yourself for Your State. Try HHS.gov and see if any info there can help you..

        • Just had call into Office , so I asked about asset recovery for persons over 55. This Legal agenda was a way that each State was able to catch those persons on PREVIOUS Medic Aid Programs, who may have sheltered assets and hidden them from qualifying limitations. In California, for Medi-CAL…you can have no assets over 2,,000.00, House – if LOW range value, is exempt and one Low range value car.also… With the ACA required plan that many are being bumped into for Medic AID…they have, at this time, as far as anyone knows, deleted all limits of assets and therefore no Liens or judgments will be placed against a MedicAid recipient at time of death, which is when they usually try to collect. UPDATES may happen, rulings may change, but thus far it is MOOT to ACA. and any NON Federal Plan….SO says California…which is all I can do verification on.

        • Kira B…. & Colleen B:

          Thank you both for the information. I am not very good at looking things up on the computer but will try to access the web site,

          Cheryl

    • A check here with the state of Washington as well as our legislative contacts indicates that the state of Washington is handling this differently, unfortunately, as I was told asset recovery is a state decision. Here asset recovery on the over 55 age group occurs when the house is sold, when death occurs or even when you are in long-term care and your home is unoccupied for a lengthy period of time and it’s thought you may not be returning to that home for some time. I have a legislator here working on the asset aspect. This is interesting as one would think it would be the same in all states but as we are in a republic with state’s that have independent governments, this is what happens. What’s even more interesting is that Washington state did accept federal dollars for the expansion so you would think that asset recovery would be out here but then again, states will have to be picking up the cost for Medicaid in two years in entirety themselves, as this is only a temporary aid from Obama and team.

      • This policy brief is one of five commissioned by the Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation on Medicaid eligibility policies for long-term care benefits. This brief provides an overview of state Medicaid Estate Recovery programs, which enable states to recoup public spending for Medicaid long-term care recipients from the estates of those recipients after their death. The remaining four briefs address: Medicaid Treatment of the Home; Spouses of Medicaid Long-Term Care Recipients; Medicaid Liens; and A Case Study of the Massachusetts Medicaid Estate Recovery Program.
        Introduction
        Medicaid imposes stringent limits on income and assets of recipients, consistent with its mission to provide a health care safety net for the poor and for those whose personal resources are insufficient to pay the full cost of care. In order to fulfill this mission, Medicaid also recovers expenses paid on behalf of recipients from their estates under certain circumstances. Medicaid is the largest source of funds for institutional long-term care expenses. It pays nearly half of the total amount spent on nursing homes, followed, respectively, by out-of-pocket funds of long-term care consumers, Medicare, private long-term care insurance, and other public and private funding sources.1
        Unless they are among the minority who have long-term care insurance, individuals contemplating paying thousands of dollars out-of-pocket every month for long-term nursing home care face the possibility of exhausting all available assets and using up their lifetime savings before being able to qualify for Medicaid. Not surprisingly, a web search on “Medicaid estate planning” yields thousands of results offering advice on a variety of strategies to qualify for Medicaid while preserving assets and savings for heirs.

    • colleen if you are 60 you can draw social security on husbands record, ss benefits may increase you income out medicaid range in 2014

      • Nope. We are self employed and turn 55 (me) and 57 (hubby) early next year. Can start drawing on some IRAs when he reaches 59 1/2, but until then I may need to get a part time job to get us above medicaid threshold. Business has picked up in the last month though, so I have really no clue what our income for 2014 will be!

    • they need to repeal medicaid and let everyone claim subsidies. if you are in yours 50S and 90′s year old parent passes away in 2014 , income off of your inheritance could increase income out of medicaid range in 2014. then what well you have do,?????????????

      • My parents drew up a trust. I made them aware of this 30 years ago. As of today they can not attach a trust

        • “And in many states if the property is inside a trust, the state may not consider the house an asset for recovery even though most states have altered their definition of estate to include a trust. “

    • How much is subject to recovery?
      At a minimum, states must recover amounts spent by Medicaid for long-term care and related drug and hospital benefits, including Medicaid payments for Medicare cost sharing related to these services. However, they have the option of recovering the costs of all Medicaid services paid on the recipient’s behalf. The majority of states recover spending for more than the minimum of long-term care and related expenses.19
      States can waive estate recovery when it is not cost-effective, as defined by the State and made public through their official State Medicaid plan.20 How states interpret the Federal guidance with respect to this issue varies. Some may waive recoveries of very small estates or make case-by-case determinations. For example, they may waive recovery when the recovery effort itself would be costly because asse

    • if you have assets and states can recover assets , might as well not go on medicaid. need to do want ever it takes to get your 2014 income out of out medicaid range.

    • if you start drawing social securty in 2014 for say only 7 months, your modified adjusted gross income well be in the medicaid range all 12 months or not at all, modified adjusted gross income is only figured one time per year, for example april 15, 2015 for 2014.

    • if were unemployed in 2012 and you started worked in 2013 and plan on worked in 2014 , i dont see how they can use 2012 income.

      • Dennis…because they have to use the latest 1040 that you have filed to VERIFY…..so that will be 2012 income tax filing …

    • this state didnt expand medicaid, so single person with income between 11490.00 — 16356.00 (58 years old) can purchase a bronze plan with a zero premium. but person with income below 11490.00 will have to pay 562.32 per month. i well be 59 and half in 2014, i can draw funds to increase magi over 11490.00 or convert money from traditional account to roth account.

    • this state doesnt ask for 2012 income. they ask if you well file a 2014 tax return. sense i have self-employment income i must file. i have to file to pay social security and medicare tax on self-employement income. they use estimated 2014 income . they ask for wages, interest, capital and all the lines on the first page of the 1040.including adjustment to income. if you can draw social security starting 2014 your 2014 income well be more 2012 and 2013s they dont not need 2012 income if state didnt expand medicaid.because the premium credit well be adjusted in 2015 when you file your 2014 on 2014 income, if you under estimate your income well owe additional premium at tax filing time, or refund if overestimate. in other words, it dont make much difference if you under estimate or over estimate income in non expanding medicaid state,. unless you want buy a plan with cost sharing subsidy . even then it want matter as long as your estimate income between 100-150% of federal poverty level or 150%-200% of fpl

    • Do I understand correctly?

      A young man, age 33, who works part-time and earns well under the threshold for Medicaid, could enroll even if he has a very large savings account balance as well as thousands in stocks and bonds, (all this recently inherited) as well as two expensive late- model cars. Would he have the option of private insurance if he didn’t want Medicaid?

      • Sure… He can have the option of private Insurance..at FULL PRICE…no subsidy. If he is under the required income and his option shows up as MedicAID…then that is all he has the two options to utilize….
        I’m in the same damn trap.

        • if you have stock account you can sell stocks each year to keep your income out of the medicaid range, you can buy the stock back the same day you sell it. i live in a state that didnt expanded medicaid and my income is below 100% of the federal poverty level, but my mom 85 years old, if something would happen to her, my income would be over 100% of the federal pvoerty level, but wouldnt have anyway of claiming the subsidies reactivilty. so l well have to keep my grandfathered plan and pay for it, if income was over 100% of fpl i could buy my currnent plan for, -0-.

    • I’m 57 year old single male. Was laid off two years ago. I’ve been paying for my own insurance since Cobra expired in 2012 at $750 a month. I have spent most of my savings of over $150,000 these last two years maintaining my home and health costs.

      I don’t have enough to live on much longer and need to find a job soon realizing I won’t be making the six figure salary I was use to. In 2012 I only made about 15,000 in freelance work. 2013 about half that.

      I have stocks worth about 60K and retirement investments worth 200K.

      Do these need to be cashed out and spent down before eligible for Medicaid? Or can I ‘guess’ what I at least hope to make next year in 2014 and put in a figure of say $25,000 which would make me eligible for a subsidy and continue paying for private insurance?

      And what happens if I do get a job and start making decent salary again?

    • mr brent ” need to enter a figure that well qualify you for subsidies, but dont buy a cost sharing subsidies plan because income may increased out of it income range, may want to buy a bronze plan estimate income as closed to want you think it well be as possible.

    • I suggest everyone read this…I understood quite a bit of the legalese..but it is a lot of double speak. Looking at State Law basically was like “Charlie Brown Sound Effect-wahwahwah”
      But the STATES are under This Federal Standing of procedure.
      I brought up the CAPITATION to the regional rep and he knew nothing of it…
      Thought he Daily KOS refers to it, it may, in fact, only pertain to State of Arizona…I am STILL trying to verify that fact….

      http://www.gpo.gov/fdsys/pkg/USCODE-2010-title42/pdf/USCODE-2010-title42-chap7-subchapXIX-sec1396p.pdf

    • people under 59 and half can convert money from traditional
      ira to roth ira get income out of medicaid range,

    • ss benefits received in year you are 62, 63, 64, and 65
      well be counted as part of your modified adjusted gross income ,
      the year you turn 65 ss recevied after 65 well be counted as income
      for the part of year you were under 65. only exception would be if
      your birthday is in january. if your birthday is in january would
      be on medicare all year. if income is in medicaid range, ss may get
      income out of medicaid range . if income is below 100% of fpl
      (state not expanding medicaid) ss may get income over 100% of
      fpl.

    • if your income is over 400% of fpl and you have child dec
      31, 2014 , that child may qualify for the subsidies for 2014, but
      child born january 1, 2015 would not qualify you for subsidies. but
      dec 31, 2014 is more than 9 months away, so you know what that
      means. but you would have to buy insurance in advance to claim
      subsidies

    • OK…done all the research to almost DONE…talked to reps , talked to supervisors, talked to Health and Human Services, talked to Legislator…..talked to FEDS.
      If you are over 55 and you are stuck with Medic Aid…they WILL go after every penny that was laid out for you while on program, after your death. There is no way to shelter it…Federal law allows it to be taken from Trusts, Probate Wills, stocks, bonds , retirement, and BENEFICIARIES..even if dispersal has occurred, they will come to your Heirs for repayment.
      Trying to jack up income doesn’t work..whether selling stocks or any other means, why?…because it places you in Capital Gains category of Taxes at very high expense…and it will not continue at same rate over years. WHY pay enormous taxes to try to be able to buy a Policy?
      SO…I, like MANY..will be stuck with having the MedicAid (MediCAL) card …to beat the mandate and Tax Fine…but I will still have no Insurance, because I will NOT use it and open my assets to confiscation by the State. They have no qualms about taking your Home and kicking your Family OUT.
      I am STILL getting the run around about Capitation system, as mentioned in AZ law, by the Article from Daily Koss…every one is playing DUMB and silent on that one. If I find I would be charged a monthly amount (as mentioned in AZ…of $3, 340 a month as lien on MedicAid, whether I use it or NOT) …then I will be having NO CHOICE, but to take NOTHING and pay the tax fine for 3-4 years, which will cost me $4-5,000 for NOTHING
      YES…this is Healthcare for Everyone….NOT