Bill Overview
Title: Stop Unfair Medicaid Recoveries Act of 2022
Description: This bill prohibits state Medicaid programs from using estate recovery to recoup the costs of benefits. States must withdraw property liens within 90 days of the bill's enactment.
Sponsors: Rep. Schakowsky, Janice D. [D-IL-9]
Target Audience
Population: People on Medicaid
Estimated Size: 85000000
- Medicaid is the primary health insurance program for low-income individuals and families.
- Estate recovery is a process where state Medicaid programs attempt to recover the costs of long-term care from the estates of deceased Medicaid beneficiaries.
- The individuals most impacted by this practice are typically older adults who have received long-term care through Medicaid.
- Removing estate recovery could potentially relieve financial burdens on the families of deceased Medicaid beneficiaries.
Reasoning
- The policy targets individuals who have been on Medicaid, particularly those who have utilized long-term care services. Given that estate recovery is a significant issue for older adults with limited assets, they are likely to represent a significant share of the affected population.
- The budget constraints mean that only a portion of the target population can be directly relieved by the placement of this policy. The simulated interviews aim to provide a cross-section of individuals, including those who stand to benefit greatly, those who might have a low positive impact, and those who will see no change.
- The financial impact of removing estate recovery can be seen in the medium to long term as families retain more wealth passed down from their deceased relatives who were on Medicaid.
- It's important to include a diverse range of interviewees in regards to geography and background to ensure a more holistic understanding of the policy's effects on different segments.
Simulated Interviews
Retired (Arkansas)
Age: 78 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- This policy lifts a huge burden off my family. Estate recovery was going to claim a significant portion of our modest estate.
- I can now ensure some level of financial security for my children and grandchildren.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Retired factory worker (Ohio)
Age: 82 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- I'm not too familiar with all the details but knowing my kids won't have to deal with estate recovery is comforting.
- My estate is not large, but whatever I can leave them will help.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 4 |
Unemployed (California)
Age: 62 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- It's good that this policy will help others, but since I don't own property, it doesn't affect me directly.
- It's still a needed change for fairness.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired teacher (New York)
Age: 90 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 7/20
Statement of Opinion:
- This policy feels like justice for those of us who worked hard all our lives but ended up with little to show for it.
- It's a relief knowing my estate won't vanish.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Part-time worker (Florida)
Age: 58 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 14/20
Statement of Opinion:
- Having an elderly parent using Medicaid, I'm concerned about estate recovery.
- This policy eases those worries significantly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Retired nurse (Texas)
Age: 70 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- I transferred property to avoid estate recovery already, so this policy doesn't change much for me personally, but it's a good move overall.
- I'm glad others won't have to go through the legal expenses we did.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Self-employed before retirement (Washington)
Age: 67 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 11/20
Statement of Opinion:
- The worry about estate recovery was a constant stress; this policy relieves that.
- I now feel my savings can be more focused on my health without the fear of losing everything posthumously.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 4 |
Homemaker (Illinois)
Age: 84 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- Although I'm not directly affected, it's comforting to know that this policy will help those who have worked hard to own a home.
- It aligns with my hopes for a fair treatment of older adults on Medicaid.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 4 | 4 |
| Year 5 | 4 | 4 |
| Year 10 | 4 | 4 |
| Year 20 | 4 | 4 |
Retired librarian (Oregon)
Age: 72 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- Knowing that my home won't be taken away after I pass makes me feel at peace.
- This policy helps ensure my grandchildren can benefit from my estate.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Retired engineer (California)
Age: 80 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 5/20
Statement of Opinion:
- We are financially secure, so this policy doesn't impact us directly, but it's ethically a sound decision.
- I'm happy that this policy supports more vulnerable groups.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Cost Estimates
Year 1: $500000000 (Low: $400000000, High: $600000000)
Year 2: $510000000 (Low: $410000000, High: $610000000)
Year 3: $520200000 (Low: $420100000, High: $620300000)
Year 5: $530404000 (Low: $430301000, High: $630505000)
Year 10: $556924204 (Low: $456621103, High: $656828305)
Year 100: $10000000000 (Low: $8000000000, High: $12000000000)
Key Considerations
- Medicaid is a jointly funded state and federal program, so both levels of government will share in the increased expenses.
- The prohibition on estate recovery could lead to fiscal benefits for households, potentially offsetting some Medicaid's public cost through minor indirect economic stimulus.