NH recently passed Medicaid expansion. This was needed in order to provide coverage for the many people whose incomes were too low to qualify for subsidized coverage under the ACA.
However, for a segment of NH residents, there is a serious downside: anyone who has subsidized coverage now, because they make 100% of the Federal Poverty Level or more, will apparently lose that coverage July 1st unless they make more than 138% of FPL.
The subsidized coverage now in place in NH for those between 100% and 138% of FPL will be replaced by Medicaid. And for those who are 55 or older, that NH Medicaid enrollment comes with a set of laws and policies that set out to recover 100% of whatever Medicaid spends on your behalf, including monthly premiums, whose amount is not known.
We are only two and a half months away from this transition, and yet apparently very little is known about exactly how it will take place. I have not heard yet, for instance, whether people will be automatically enrolled, or have a chance to opt out.
The estate recovery aspect of the situation seems to have largely escaped notice until now. But now it really must be addressed, and first of all it must be addressed by having the facts widely understood and discussed.
I think we must consider the example recently brought to our attention in GreenMother's diary, of the government deciding that it can collect decades old overpayments, reportedly without much if any documentation, from the children of those who were (supposedly) overpaid. How is anyone going to know, possibly decades after the fact, that the bills being collected by Medicaid are accurate?
Should such bills even be collected at all? The whole idea of taking monthly premiums and spreading them out across the lowest income segment of a population, to be paid in the end only by those frugal enough to have any assets left at death, seems backwards. Especially when people who make a dollar more per year than some of these people will have well subsidized coverage with no estate recovery.
Given the amount of the expansion paid for by the federal government, and that CMS says they want to encourage states not to impose estate recovery for ACA enrollees not receiving long term care - why is CMS or some other entity of the federal government not able to put a stop to this?
As I have mentioned before, this policy will especially impact single people, as FPL per person in a married couple is considerably lower. As women often have lower incomes than men, it will disproportionately affect women.
And yes, this affects me personally. I am 57, co-own a house, and might have a MAGI less than 138% of FPL this year.