In The People's Blog

Did you know that many low-income people with MassHealth coverage who are over age 55 have to pay back the state for the cost of their medical care — after they die?

It’s true: The “Estate Recovery” program even requires heirs to sell their home and take other steps to find the money to pay the state for the assistance they received.

This is wrong.

That’s why, in partnership with Rep. Christine Barber, I have proposed legislation to halt this process during the COVID pandemic, while a long-term solution can be worked out. (Spoiler alert: I’ll be filing that long-term solution next session.)

Our bill has just been given a hearing.

I need your help to put a pause on this practice by sending in testimony by Friday to the Judiciary Committee Co-Chairs at Claire.Cronin@mahouse.gov and James.Eldridge@masenate.gov in support of An Act to address estate recovery issues due to COVID-19.

What’s the problem:

Federal law requires states to recover its costs after a Medicaid patient dies, but only from people over 55 who received long-term care. Massachusetts, however, goes beyond federal requirements and often seeks estate recovery for the costs of all medical services provided to those age 55 and older, even if they have never received nursing home care. Over 90 percent of recoveries come from the sale of the family home.

State law and regulations impose strict timelines for objections to this process based on hardship to the surviving family members. Additionally, the state charges 12 percent interest on these claims that begins to run soon after the claim is filed!

During the COVID-19 pandemic, MassHealth members age 55 and older are at increased risk of death, and 60 percent of all COVID-19 fatalities have been among residents of long-term care. MassHealth has not stopped filing claims against the estates of any MassHealth member age 55 or older or nursing home resident who has died leaving a probate estate.

This is causing great hardship to the spouses and families who, in addition to dealing with the loss of a loved one, must negotiate the probate process at a time when the economy is in peril, in-person communications are largely eliminated, and navigating state and federal agencies and courts is complex at best. It is extremely difficult to meet the deadlines in the estate recovery statute.

Families of deceased individuals and their representatives are unable to gather the necessary information to defend against claims that may be excessive or subject to waiver on hardship grounds in the time allowed. Families required to sell real estate are unable to safely empty the house and ready it for sale. Family members living in the house may be unable to safely relocate.

While families try to manage the demands of estate recovery, MassHealth continues to charge 12 percent interest on claims. With COVID raging, we should excuse the families from having to meet the demands of estate recovery while watching the claim increase monthly at a 12 percent rate.

Requiring the sale of real estate and the quick turnaround of estate recovery claims is creating an unreasonable burden on families already facing economic hardship and grief.

What my bill would do:

S.2818 and H.4978 (filed by Rep. Christine Barber) would make estate recovery more manageable and reasonable during the COVID-19 state of emergency by recognizing the additional burdens now placed on low-income families.

Section 1: extends the 60 days limit to 180 days for the estate to respond to MassHealth regarding claims against the estate.

Section 2: waives the 12 percent interest charged on MassHealth claims during the state of emergency and for the following 180 days.

Section 3: prohibits MassHealth from taking any action to compel the sale of real estate to meet an estate recovery claim during the state of emergency and the following 180 days if an individual lives there.

Sections 4 and 5: set a sunset provision for this bill at 180 days after the end of the COVID-19 state of emergency.

For further reading on estate recovery: 

Medicaid, the government program that provides health care to more than 75 million low-income and disabled Americans, isn’t necessarily free. It’s the only major welfare program that can function like a loan. Medicaid recipients over the age of 55 are expected to repay the government for many medical expenses—and states will seize houses and other assets after those recipients die in order to satisfy the debt. …

If home ownership is one of the greatest means of upward mobility, then estate recovery, a program that strips property from the people who stand to benefit from it the most, is an insidious obstacle, perpetuating cycles of poverty and pushing displaced families back into the welfare system.

-Medicaid’s Dark Secret, by Rachell Corbett

Atlantic Magazine, October 2019

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