Beth Duffy’s Sept. 13 column “Estates could owe Medicaid” in which she raised concerns about how estate recovery rules will create a “tragic new cycle of poverty” for unwitting enrollees in Iowa’s expanded Medicaid program was shockingly misguided. She implied, incorrectly, that the Medicaid estate recovery rules that require states to recover Medicaid payments from a deceased’s estate will apply to the tens of thousands of uninsured young people and children for whom the Medicaid expansion is designed to help. Duffy ignores the fact that the Medicaid estate recovery rules do not apply to most people who are younger than 55.
The section of the Iowa Code she cites in her column says as much. It states, “The provision of medical assistance to an individual who is fifty-five years of age or older, or who is a resident of a nursing facility, intermediate care facility for persons with an intellectual disability, or mental health institute, who cannot reasonably be expected to be discharged and return to the individual’s home, creates a debt due the department from the individual’s estate for all medical assistance provided on the individual’s behalf, upon the individual’s death.”
Iowa’s estate recovery program was designed to recoup Medicaid spending for nursing home costs. It does not apply to children who see a doctor for a high fever or to pregnant women who need prenatal care. Why did Duffy neglect to mention that?
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