LTC Bullet:  The Medicaid Long-Term Care Reform Act of 2012

Friday, October 5, 2012


LTC Comment:  Congressional sponsors of the Medicaid LTC Reform Act of 2012 (H.R. 6300) ask state Governors trenchant questions about easy Medicaid LTC eligibility after the ***news.*** [omitted]


LTC Comment:  Congressman Charles W. Boustany, Jr., MD (R, LA) introduced the Medicaid Long-Term Care Reform Act of 2012 (H.R. 6300) on August 2, 2012.  This legislation advances the cause of responsible LTC planning and rational LTC public policy.  Co-sponsors are Gingrey, Blackburn, Tiberi and Westmoreland.  The short description of H.R. 6300 and the full text can be found on  A few of its major features follow. 

  • Sense of Congress resolution to repeal CLASS, discourage middle class dependency on Medicaid, encourage private LTC insurance, educate the public about LTC planning, improve the LTC Partnership program, and allow states to target Medicaid to the most needy.
  • Compels the HHS Secretary to provide technical assistance to states on LTC Partnerships and Medicaid estate recoveries.
  • Requires the National Clearinghouse for LTC Information to increase the number of middle class people who receive information about the limitations of Medicaid and Medicare and the alternatives for private LTC financing.
  • Directs the HHS Secretary to evaluate ways to . . .

1.      Expand LTC insurance coverage

2.      Solicit ideas from listed stakeholders on ways to reduce state and federal Medicaid expenditures

3.      Consider block granting Medicaid LTC

4.      Study the effectiveness of Medicaid asset eligibility rules, estate recovery, and transfer of assets penalties.

5.      Ascertain potential savings from policy options evaluated.

  • Requires the HHS Secretary to report to Congress no later than January 1, 2014 with recommendations based on the policy options considered in the preceding reviews.
  • Requires the Secretary to consult with a list of experts including the Center for LTC Reform.
  • Mandates the Director of the Congressional Budget Office to report on . . .

1.      The percentage of middle class people who will rely in the next 20 years on Medicaid for LTC services compared to the percentage that will rely solely on private financing from savings, home equity or insurance. 

2.      The cost of such reliance on Medicaid.

3.      The likely impact of potential policy options such as reducing Medicaidís home equity exemption to $200,000 or $50,000; extending the transfer of assets look back period to 10 years; expanding the use of liens to preserve property for later estate recovery; and allowing LTC insurance to be included in employer ďcafeteria plans.Ē

4.      The potential savings from such policy options if Medicaid were block granted to the states.

  • Precludes any proposal that requires the enrollment of individuals in a specific program or insurance product.

What do our nationís Governors think of the Medicaid Long-Term Care Reform Actís objectives?  Thatís what the billís sponsors seek to find out in a letter mailed to Governors on September 14, 2012, a sample of which weíve provided below. 

After laying out some facts and principles about Medicaid and long-term care financing, the letter asks Governors these questions:

  1. Should the federal government give states greater flexibility to consider assets, including substantial home equity, when determining eligibility for long-term care coverage through the Medicaid program?  Why or why not?
  1. Please provide examples of barriers to effective Medicaid estate recovery programs and tools that might help states in this area.
  1. Should state and federal governments encourage middle-income Americans to anticipate and plan for their future long-term care needs, instead of relying on Medicaid, a safety net for the poor?  Why or why not?
  1. Do you consider Medicaid estate planning to be a significant problem that takes resources from the truly needy in your state?  Please explain and provide examples.

Interested in your Governorís reply?  Why not forward this LTC Bullet to him or her and ask?  You can find a list of the Governorsí email addresses here:

Who can object to saving Medicaid for those in need?  Certainly not advocates on the left who represent the poor.  Not financial conservatives on the right who seek fiscal responsibility.  Targeting Medicaidís scarce LTC resources to people in need and encouraging others to plan responsibly for long-term care just makes objective sense, regardless of oneís political orientation or ideology.

Following is the letter Congressional sponsors of the Medicaid Long-Term Care Reform Act sent to Governors.  Note that the bill number cited in the letter is incorrect.  It should be H.R. 6300.