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State and federal regulation

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Massachusetts

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As of 2017, Massachusetts reports the highest rate of insured citizens in the United States at 97%.[1][2] However, because of much of the 97% "insured" number in Massachusetts is from people covered under Medicaid and expanded Medicaid, and because Massachusetts does Medicaid estate recovery for ordinary health insurance expenses for people who were 55 or older when they were covered [3][4], (who can therefore, in one view, be considered not insured, but rather as having just a loan for uninsured medical expenses.[5][6][7][8][9][10] ), it can be argued that the true "insured" rate is perhaps 4% lower than reported.

Public health care coverage

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Medicaid benefits are, depending on the type of benefit and state, subject to Medicaid estate recovery. Federal Medicaid law requires states to recover long-term-care-related expenses, and also gives them the option of recovering all other expenses, including ordinary health-insurance expenses, from people 55 and over.[11][12]

Certain states (including, but not limited to, MA, NJ, IA, NV, NH, ND, OH, RI, IN, ID, UT, and MD, as well as the District of Columbia[4][3][13][14]) currently recover non-long-term-care-related Medicaid expenses, including for the ACA's expanded Medicaid. Other states do not.[15][16][17][18][19][20][21][22][23][24][25][26][14]

it can be viewed that in states that recover non-long-term-care-related Medicaid expenses, people 55 or older covered through Medicaid or the ACA's expanded Medicaid really have no health insurance at all, in the ordinary conception of "insurance". Medical expenses are paid for the person now, but all medical expenses that were paid out can be recovered from the estate of the person when they die. The Medicaid coverage is in some views most accurately classified as a loan until death.[5][6][7][8][9][10] (However, the U.S. Census Bureau does currently count people with all forms of Medicaid as "insured"[27], regardless of whether medical bills paid are subject to estate recovery.)

In 2011, there were 7.6 million hospital stays billed to Medicaid, representing 15.6% (approximately $60.2 billion) of total aggregate inpatient hospital costs in the United States.[28]

References

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  1. ^ LeBlanc, Steve (13 March 2017). "Baker: Keeping Uninsured Rate Low Is Key in Massachusetts". Associates Press. Retrieved 3 August 2017.
  2. ^ Freyer, Felice J. (17 September 2016). "Rate of uninsured in Mass. reaches all-time low". Boston Globe. Retrieved 3 August 2017.
  3. ^ a b "MassHealth General Policies. (See estate recovery sections 515.011 and 515.012)" (PDF). 2019-08-14. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  4. ^ a b "MA ACA application. See conditions (9) and (10) on adobe p. 22" (PDF). 2019-08-14. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  5. ^ a b Stein, Sam (2014-01-27). "Latest Obamacare Horror Provision Was Championed By ALEC". HuffPost. Retrieved 2019-08-27.
  6. ^ a b "Medical Assistance Estate Recovery". Marshall, Parker & Weber LLC. 2012-09-27. Retrieved 2019-08-27.
  7. ^ a b "Estate Recovery - It's Worse Than You Thought". Daily Kos. Retrieved 2019-08-27.
  8. ^ a b "Medicaid Estate Recovery Documenet (American Association of Public Welfare Attorneys)" (PDF). 2019-08-27. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  9. ^ a b Ostrom, Carol M. (2013-12-16). "Expanded Medicaid's fine print holds surprise: 'payback' from estate after death". The Seattle Times. Retrieved 2019-08-27.
  10. ^ a b "Medicaid Estate Recovery + ACA: Unintended Consequences?". Daily Kos. Retrieved 2019-08-27.
  11. ^ "Medicaid's Power to Recoup Benefits Paid: Estate Recovery and Liens". ElderLawAnswers. Retrieved 2019-08-14.
  12. ^ "Estate Recovery and Liens". www.medicaid.gov. Retrieved 2019-08-14.
  13. ^ "New Jersey Medicaid Estate Recovery Document" (PDF). 2019-08-14. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  14. ^ a b "Medicaid estate recovery", Wikipedia, 2019-08-26, retrieved 2019-08-27
  15. ^ "GIS 14 MA/016: Long Term Care Eligibility Rules and Estate Recovery Provisions for MAGI Individuals". www.health.ny.gov. Retrieved 2019-08-14.
  16. ^ "NY State Medicaid and Other Programs Application (see p. 23)" (PDF). 2019-08-14. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  17. ^ Becker, Arielle Levin; April 9, The CT Mirror; 2014 (2014-04-09). "CT scales back Medicaid repayment rules for some recipients". The CT Mirror. Retrieved 2019-08-14. {{cite web}}: |last3= has numeric name (help)CS1 maint: numeric names: authors list (link)
  18. ^ "Federal CT Medicaid Waiver 14-022" (PDF). 2019-08-14. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  19. ^ Ostrom, Carol M. "State will change asset recovery policy for Medicaid enrollees". The Seattle Times. Retrieved 2019-08-14.
  20. ^ "Estate Recovery | Washington State Health Care Authority". www.hca.wa.gov. Retrieved 2019-08-14.
  21. ^ Hunsberger, Brent (2013-12-02). "Cover Oregon: State says it won't pursue Oregon Health Plan recipients' assets". oregonlive.com. Retrieved 2019-08-14.
  22. ^ "Oregon State Medicaid Estate Recovery Document" (PDF). 2019-08-16. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  23. ^ "Medical Recovery Pamphlet from CANHR" (PDF). 2019-08-06. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  24. ^ "Estate Recovery". www.dhcs.ca.gov. Retrieved 2019-08-14.
  25. ^ Gazette, Moose Lake Star. "Minnesota MA estate liens put to final rest". Moose Lake Star Gazette. Retrieved 2019-08-14.
  26. ^ joseph. kempf. "Estate recovery". Minnesota Department of Human Services. Retrieved 2019-08-14.
  27. ^ "Health Insurance Coverage in the United States: 2017" (PDF). 2019-08-14. {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  28. ^ Cite error: The named reference hcup-us.ahrq.gov was invoked but never defined (see the help page).
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