Talk:Medicaid/sandbox

Medicaid Estate Recovery
States are required to recover long-term-care-related (LTCR) Medicaid expenses from the estates of people 55 or older when they received Medicaid, to the extent of at least probate estates. States also have the option to recover costs of all medical care for people who were 55 or older, and have a separate option to extend the recovery beyond a probate estate. This latter option is generally called "expanded estate recovery".

When the estate recovery is applied to medical expenses, since it be a recovery of all medical expenses paid out, and not just some sort of actuarial premium equivalent, it can be argued that people with the Medicaid really have no health insurance at all, in our ordinary conception of insurance. The Medicaid coverage could most accurately be viewed as a "loan until death for uninsured medical expenses".

Since many states, before the ACA, elected to do Medicaid estate recovery for the costs of all medicare care for people 55 and older, and have not adjusted laws since, and since the ACA includes expanded Medicaid, which counts as a Medicaid for estate recovery purposes, the "health insurance" provided by Medicaid and the expanded Medicaid part of the ACA for people 55 and older in many states may not really be what we would normally think of as insurance, although it is counted as health insurance in the Census Bureau and most other statistical reports of health insurance coverage.