Apparently Gov. Cuomo has put the spousal refusal provision for Medicaid back on the list of possible cuts again in this year’s budget. The Staten Island Advance editorial says:
…The governor wants to eliminate the so-called “spousal refusal” provision that allows New Yorkers even at higher income levels to get Medicaid reimbursements for long-term care. The state Health Department says that doing so, would save taxpayers up to $100 million or more a year.
Spousal refusal allows the healthy spouse in a marriage to essentially divest the assets of a husband or wife in need of long-term care. In that way, the family need not spend the bulk of its own assets to pay for that care…
According to Republican Assemblywoman Nicole Malliotakis, who recently wrote a letter to the Advance opposing the governor’s plan, “Spousal refusal allows for a healthy spouse, known as the community spouse, to protect their entire life savings from being garnished by the government to supplement the massive expense related to assisted living and long-term care.”
She said that with it in place, the healthy spouse is allowed to keep the family home, a car and up to $113,640 in assets. Were the spousal refusal provision to be eliminated, the couple would have to live the rest of their lives with just $20,850 in assets.
As she notes, this would hit middle-class families particularly hard. Even younger families with children in which one spouse is stricken with a catastrophic illness would be wiped out.
Without the provision (which NY is fairly unique in having), couples have to spend down all their life savings or consider divorce in order to protect assets for the well spouse so they can get long term care through Medicaid for the ill spouse. (Keep in mind there is no long term care provision in Medicare, and private long term care insurance is prohibitively expensive for most.)
Here’s a piece I wrote at Huffington Post’s New York page one year ago, when he also tried this: “Gov. Cuomo Should Not Jettison the “Spousal Refusal” Allowance in State’s Medicaid Program“:
…Critics charge that New York’s spousal refusal allowance benefits wealthy New Yorkers who get to protect their assets while using Medicaid to care for their sick spouse. But let’s face it: people with resources want to pay for the best quality, most attractive and most home-like long-term care settings, which often don’t accept Medicaid. Those who will really suffer under the governor’s proposed change are elderly middle and low-income New Yorkers, people who worked hard all the years they were healthy and should not callously be forced into divorce by the state in order to get the health care they need.