HHS Secretary Kathleen Sebelius
The Obama administration will issue new policy guidance to states today, expanding states' ability to extend equal long-term care coverage under Medicaid to same-sex couples as straight couples receive, according to an exclusive
from the Washington Blade.
Under the new guidance, dated June 10, states have the option to allow healthy partners in a same-sex relationship to keep their homes while their partners are receiving support for long-term care under Medicaid, such as care in a nursing home.
Medicaid kicks in for a beneficiary to receive care after an individual depletes virtually all of their money. To pay for the beneficiary’s expenses under Medicaid, a state could impose a lein, or take possession, of a beneficiary’s home to pay for Medicaid expenses.
However, federal law prohibits imposing this lein if beneficiaries are married to someone of the opposite-sex who’s still living in their home. The new guidance, signed by Deputy Administrator of the Centers for Medicare & Medicaid Services Cindy Mann, clarifies that states can offer this protection to the healthy partner of a Medicaid recipient in a same-sex relationship.
“A State can have a policy or rule not to pursue liens when the same-sex spouse or domestic partner of the Medicaid beneficiary continues to lawfully reside in the home,” the guidance states.
This is a guidance, rather than a mandate, so states will not be mandated to provide this protection to same-sex spouses, but it is intended to clarify for states that the Defense of Marriage Act would not preclude states from providing this protection.
In a statement, Health and Human Services Secretary Kathleen Sebelius got to the key element of this action: "Low-income same-sex couples are too often denied equal treatment and the protections offered to other families in their greatest times of need. That is now changing. Today's guidance represents another important step toward ensuring the rights and dignity of every American are respected by their government."
It's a relatively small step, as long as DOMA remains on the books, but it does provide more security to couples having to face the already difficult situation of having a partner in long-term care.