Expanded Medicaid’s fine print gives middle-age adults big jolt

The Seattle TimesDecember 16, 2013 

Sofia Prins and Gary Balhorn, both 62, decided to marry so they wouldn’t have to get health insurance individually through Medicaid, which could bill their estates after death. The Port Townsend couple’s joint income is too high for Medicaid but low enough for tax credits.

BETTINA HANSEN — The Seattle Times

It wasn’t the moonlight, holiday-season euphoria or family pressure that made Sophia Prins and Gary Balhorn, both 62, suddenly decide to get married.

It was the fine print.

As fine print is wont to do, it had buried itself in a long form — Balhorn’s application for free health insurance through the expanded state Medicaid program. As the paperwork lay on the dining-room table in Port Townsend, Prins began reading.

She was shocked: If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.

The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs, Prins said.

With an estimated 223,000 adults seeking health insurance headed toward Washington’s expanded Medicaid program over the next three years, the state’s estate-recovery rules, which allow collection of nearly all medical expenses, have come under fire.

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