Norman Spier: Estate recovery reforms welcome

I’d like to thank state Sen. Jo Comerford for her work over several years, resulting in a provision recently signed into state law (H5033), limiting Massachusetts’ formerly excessive estate recovery to the federally required minimum. Although it’s a kind of a legal detail that makes many people’s eyes glaze over, it’s an important provision, needed to make the Affordable Care Act work to make people less financially at risk from medical costs.

Many states have already adopted this provision, starting way back in 2014 when the ACA’s main provisions went into effect. It used to be that when you went to the Massachusetts Health Connector site and signed up for your annual health coverage under the ACA, if your income for that time period happened to be below 138% of the federal poverty level (regardless of how much in assets you have), they would give you ACA expanded Medicaid (as MassHealth) as your coverage, which under state law could be recovered from your estate at your death, potentially to the full amount of medical bills paid out. Which could be hundreds of thousands of dollars!

So, thanks to Sen. Comerford (working with state rRep. Christine Barber), we are now protected from that danger. To not give people a false sense of medical expenses security, Massachusetts and the country as a whole still has lots of things for people to worry about in terms of health care costs that aren’t a worry in many other countries.

For long-term care, as in nursing homes, federal law requires estate recovery, so Comerford’s bill can not block that. More importantly, without a long-term care insurance system, many people risk getting financially wiped out by nursing home expenses, which are not covered by the ACA. The issue of such long-term-care expenses probably needs a national solution, due to cost, and unfortunately, such a federal solution is probably not in the cards for any time soon.

Norman Spier

Easthampton