(Editor’s note: The Boston Globe ran a story about this issue on January 3, 2016.)
To the editor:
Recently proposed changes to MassHealth eligibility requirements would make it harder for residents older than 65 to establish special-needs trust accounts and still qualify for nursing home care and other health services from state and federal government agencies. The changes would force disabled seniors to spend down their personal financial resources, including held money in a trust, before qualifying for MassHealth benefits. Special-needs trusts allow seniors to pay for extra benefits, such as dental work or a home health aide that are not covered by MassHealth. They have traditionally been exempt from MassHealth income calculations, allowing disabled seniors and families to plan for long-term care and provide them with small comforts that improve their quality of life.
According to MassHealth officials, the changes are being pursued in order to comply with 2008 federal Medicaid guidelines which advised states that disabled individuals over 65 wouldn’t be able to transfer money into a pooled trust without a penalty. However, since MassHealth proposed the special-needs trust revisions, officials from the Centers for Medicare and Medicaid Services (CMS) have pointed out that there are other factors that determine Medicaid eligibility when it comes to trusts and transfers, such as how much money is in a trust and why it was deposited. CMS officials also point out that they don’t necessarily exempt one from becoming eligible for Medicaid if an individual has a special-needs trust.
Long-term care costs make up a large percentage of the MassHealth budget as the median annual cost for a shared room at a nursing home in Massachusetts is $135,000. While it is important for MassHealth to rein in costs to ensure a sustainable future for the agency, any changes to the eligibility requirements in regards to special-needs trusts should be looked at with strict scrutiny. I am very much opposed to these changes and will work with my colleagues in the legislature on measures to reverse them should MassHealth move forward.
Mass. Rep. Thomas M. Stanley (D-9th Middlesex)
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