Medicaid’s New Adult Group and Estate Recovery

Since 1993, Medicaid has required states to pursue recovery from the estates of deceased beneficiaries for long-term services and support benefits paid on their behalf. Although Medicaid does not require states to recover payment for other types of services, 35 states and the District of Columbia have elected to do so. Twenty-four of these jurisdictions have also expanded Medicaid to non-disabled adults under the Patient Protection and Affordable Care Act, prompting concern that some newly eligible adults may choose not to enroll in Medicaid due to fear of estate recovery. This issue brief provides an overview of current Medicaid policy on estate recovery and its rationale, including states’ and the Centers for Medicare & Medicaid Services’ efforts to limit estate recoveries.