Tag Archives: Medicaid

Medicaid, Obamacare, and LGBT People

Last week’s Supreme Court decision upholding the constitutionality of most of the provisions of the Affordable Health Care Act (popularly known as “Obamacare”) left in place upcoming changes to Medicaid that will particularly help low-income LGBT people.

The new law permits states to expand Medicaid coverage to all Americans under the age of 65 who make less than $15,000 per year (the Supreme Court struck down the provision that would have withheld ALL Medicaid funds from states that refused to do so, making this now a truly optional program).  This provision could provide care to an additional 16 million currently uninsured people, including many LGBT people, who on average have less income than non-LGBT people.  The provision also extends Medicaid coverage to people living with HIV earlier in the course of the disease, again affecting a disproportionate number of LGBT people.

A blog post on this topic, written by two health policy analysts for LGBT Progress, is available at http://thinkprogress.org/lgbt/2012/06/28/508590/how-medicaid-expansion-affects-gay-and-transgender-communities/

Advocates’ Map to LGBT Medicaid Spousal Impoverishment Protections

If you are an advocate who wants to protect same-sex partners from being ousted from their homes and losing income they need to live on when their partner needs Medicaid help to pay for nursing home care, the Williams Institute has issued a must-have guide:  “Extending Medicaid Long-Term Care Impoverishment Protections to Same-Sex Couples,” available at http://williamsinstitute.law.ucla.edu/research/marriage-and-couples-rights/medicaid-reports-june-2012/

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Retirement Planning Checklist for LGBT Americans

Reuters has published an checklist for LGBT Americans planning retirement which includes a couple juicy statistics.

The article, available at http://www.reuters.com/article/2012/06/21/us-column-miller-lgbtretirement-idUSBRE85K12N20120621, urges LGBT adults to:

  • Check your 401(k) beneficiaries, as starting in 2010, you’re allowed to list non-spouse beneficiaries;
  • Check your pension survivor benefits; 73% of corporations now offer a survivor option for domestic partners;
  • Check your retiree health insurance; if you’re one of the lucky ones whose corporation will pick up your post-retirement health insurance bill, there’s a 44% chance they will extend that coverage to your domestic partner;
  • Think about estate taxes; starting in 2013, if your same-sex spouse will inherit more than $1 million from you (or vice versa), the federal estate tax will take 55% of it.  Alternatives include a life insurance policy and annual tax-free gifts up to $13,000; and
  • Consider lobbying your state to have it implement spousal impoverishment rules that will protect the spouses/partners of LGBT people whose nursing home bills are paid by Medicaid.  (See previous posting for a webinar on this legislative issue.)

Medicaid Spousal Impoverishment Webinar

On Wednesday, June 27, 2012, from 11:00 a.m. to noon Pacific time, the Williams Institute is hosting a webinar on Medicaid spousal impoverishment and same-sex couples.

Medicaid pays most people’s nursing home bills, but one has to have nearly no assets to qualify.  For couples, that used to mean BOTH people had to become “impoverished.”  Congress fixed this problem many years ago for heterosexually married couples, allowing the well spouse to keep their home and some income while still paying for the care the nursing home resident used.  The Obama Administration recently sent all states an advisory memo saying states are empowered to also protect same-sex couples, but states have to implement this choice.  The Williams Institute webinar “is designed to provide policy guidance to state policymakers and advocates interested in implementing these protections in their respective states.”  Scheduled speakers include:

  • Michael Adams, Executive Director of SAGE
  • Christy Mallory, Reid Rasmussen Fellow of Law & Policy, the Williams Institute
  • Jennifer C. Pizer, Legal Director and Arnold D. Kassoy Senior Scholar of Law, the Williams Institute
  • Sherrill Wayland, Executive Director, SAGE Metro St. Louis

RSVP for the webinar at http://williamsinstitute.law.ucla.edu/events/upcoming-events/medicaid-webinar-062712/

States Offered Medicaid Same-Sex Spouse Options

In yet another instance of the Obama Administration reaching as far as it legally can to protect LGBT people, the Centers for Medicare and Medicaid Services this month issued a letter to state Medicaid administrators explaining how they can, if they so choose, protect same-sex spouses and domestic partners in much the same way that heterosexual spouses are protected.

Specifically, the letter addresses three Medicaid policies that relate to how a nursing home resident “spends down” their assets so that they become eligible for Medicaid.  Many years ago, federal changes were enacted that ensured that “community-dwelling” spouses weren’t thrown from their houses or deprived of all their assets when their nursing home resident partner became eligible for Medicaid.   Because of the Defense of Marriage Act (DOMA), these provisions can not be extended to same-sex spouses…except if states follow the guidance in this new letter.

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