Source: United States House of Representatives – Congresswoman Jan Schakowsky (9th District of Illinois)
Full Text of Bill (PDF)
WASHINGTON — Today, U.S. Representative Jan Schakowsky (IL-09), Co-Founder and Co-Chair of the House Democratic Task Force on Aging and Families, reintroduced the Stop Unfair Medicaid Recoveries Act, legislation to end the federal requirement that forces states to pursue repayment from the families and estates of deceased Medicaid recipients who received long-term care.
Under current law, state Medicaid programs are required to recover the costs of long-term care services after a beneficiary’s death, which often results in placing liens on or forcing the sale of a family home. Even when states recognize the harm caused by this practice, federal law leaves them little choice.
“Families should not face financial ruin while they are grieving the loss of a loved one,” said Congresswoman Schakowsky. “Yet every year, thousands of families are shocked to learn that Medicaid is demanding repayment, which sometimes totals hundreds of thousands of dollars, for care their loved one needed. Too often, the only way states can recover this money is by seizing the family home, wiping out generational wealth and causing immense emotional and economic harm.”
The Medicaid Estate Recovery program is little known but widely destructive. Since 2021 alone, thousands of Illinois families have lost their properties as a result of this mandate. Nationwide, the policy disproportionately harms low-income families, blue-collar households, and communities of color.
“Medicaid is the only public benefit program that requires families to pay back the cost of care after a beneficiary’s death,” Schakowsky continued. “This policy keeps families in poverty, discourages seniors and people with disabilities from seeking care, and fails to meaningfully offset Medicaid costs. This ineffective program recovers less than 1% of total long-term care spending. It is unjust and cruel.”
Consider the case of a widow who owns a modest $90,000 home and has two adult children with limited incomes. After suffering a stroke, she spends her final years in a nursing home, with most of her care covered by Medicaid. Following her death, her children receive a bill for $150,000 in nursing home costs, which forced them to sell the family home and surrender every dollar to the state.
“This is not how our nation should treat its seniors or their families,” Schakowsky said. “We need a real, humane long-term care policy that provides dignity, security, and peace of mind. I am proud to reintroduce this bill and will continue fighting to end this cruel and unnecessary practice.”
The Stop Unfair Medicaid Recoveries Act would repeal the federal estate recovery mandate and prohibit harmful practices such as placing liens on a Medicaid recipient’s home during their lifetime. The legislation would give states the flexibility to protect families while preserving access to long-term care.
“By forcing the sale of family homes, Medicaid estate claims keep families in poverty, perpetuate the racial wealth gap, and increase the risk of homelessness,” says Eric Carlson, Director of Long-Term Services and Supports Advocacy, Justice in Aging. “The Stop Unfair Medicaid Recoveries Act will relieve low income older adults from having to choose between getting the care they need or risking their family home.”
“Estate recovery laws punish families simply because a loved one with a disability needs long-term services and supports through Medicaid. These policies allow the government to take homes from low-income families, undermining their stability and blocking opportunities to build even modest wealth, particularly harming families of color. At a time when access to both health care and housing is more urgent than ever, the National Health Law Program strongly supports the Stop Unfair Medicaid Recoveries Act and urges the 119th Congress to end this harmful and inequitable practice,” said Jennifer Lav, Director, Disability Practice Area, National Health Law Program.
“National Academy of Elder Law Attorneys (NAELA): “NAELA is extremely grateful to Representative Schakowsky for continuing to bring attention to this important issue. Our members frequently work with individuals who are trying to balance their need for Medicaid’s long-term services with a desire to pass along their family home to the next generation. No one should have to make that choice.” said Alexander T. Graham, Chief Executive Officer, National Academy of Elder Law Attorneys.
“Consumer Voice is extremely grateful to Representative Schakowsky for reintroducing this bill. The estate recovery program is an outdated system that punishes low income Medicaid recipients and their families who take advantage of long term care supports and services. It also serves as a barrier to access to services, since many eligible individuals forgo necessary care out of fear of losing their home. This bill would make access to LTSS easier, remove the financial and housing burden on low income families, and ensure that individuals are able to receive care without fear of repercussion,” said Sam Brooks, Director of Public Policy, Consumer Voice for Quality Long-Term Care.
The Stop Unfair Medicaid Recoveries Act is cosponsored by Reps. Nanette Barragán (CA-44), Kathy Castor (FL-14), Sheila Cherfilus-McCormick (FL-20), Steve Cohen (TN-09), Lloyd Doggett (TX-37), Sylvia García (TX-29), Dan Goldman (NY-10), Eleanor Holmes Norton (DC-AL), Robin Kelly (IL-02), Doris Matsui (CA-07), Alexandria Ocasio-Cortez (NY-14), Ilhan Omar (MN-05), Chellie Pingree (ME-01), Mike Quigley (IL-05), Delia Ramirez (IL-03), Marilyn Strickland (WA-10), Paul Tonko (NY-20), Lori Trahan (MA-03), and Debbie Wasserman Schultz (FL-23).
The Stop Unfair Medicaid Recoveries Act is endorsed by Justice in Aging, National Health Law Program, National Academy of Elder Law Attorneys (NAELA), the National Consumer Voice for Quality Long-Term Care, and the Epilepsy Foundation.
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