This would increase the number of Medicare beneficiaries eligible for full-benefit Medicaid by about 1.7%. The first is to update the test based on rates of inflation since their implementation in 1989. She and her team examined similar programs, recent policy proposals and solutions already used by individual states to propose four potential solutions to alter the Medicaid asset test. Pitt Public Health doctoral student Noelle Cornelio spoke with state Medicaid administrators and built a database compiling each state's asset test rules from 2006 through 2018. Determining assets can be burdensome, requiring state Medicaid administrators to account annually for all the investments, savings and property of each enrollee.īecause the test was created without factoring in inflation, someone with just $900 in savings who would have been eligible in 1989 is now ineligible with the equivalent inflation-adjusted savings of just over $2,000. In most states that test was set in 1989 at $2,000 in assets for a single enrollee and $3,000 for a couple. Medicare recipients have to undergo an 'asset test' to determine whether or not they can dual-enroll in Medicaid.

That means vulnerable people often choose between maintaining modest savings while paying out of pocket for medical care and depleting their savings in order to qualify for Medicaid.Ībout 8.7 million low-income elderly or disabled people enrolled in Medicare are also enrolled in full-benefit Medicaid through the state in which they live, with Medicaid covering Medicare premiums, co-pays and other services, such as vision and dental. In addition to discouraging savings, the asset limits create other unintended consequences, such as perpetuating disparities by favoring those who can better navigate complicated public programs and financial decisions.

This increasingly hampers the incentive for many vulnerable older people to maintain even modest savings, generally equivalent to a few months' rent.

In most states, limits on the value of assets held by low-income seniors restrict eligibility for supplemental Medicaid coverage, and no adjustments for inflation have been made over three decades, data showed. In a new analysis in the December issue of Health Affairs, University of Pittsburgh Graduate School of Public Health scientists propose four solutions states could implement to improve Medicaid eligibility for seniors, particularly for Medicare enrollees who are non-white or report being in poor health.Īdditional costs to states could be offset by lower administrative burdens and potentially improved health of enrollees.

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