Medicaid Crisis May Force States to Require Adult Children to Pay For Aging Parents

Saturday, September 5, 2009

Medicaid is a jointly funded Federal and State health insurance program for low-income and needy people. Normally it covers children, the aged, blind and/or disabled. It may also cover people who are eligible to receive federally assisted income maintenance payments.
Because it is jointly run by the states and the Federal government, rules will vary from state to state. Even the name of the program varies from state to state. California calls its Medicaid program MediCal. Georgia calls its program Georgia Better. Connecticut often calls its Medicaid program just Title 19.

Whatever the program may be called, it is clear that without dramatic reform, Medicaid costs are expected to double by 2017. In 2008 the federal government spent $4.13 billion and expected 2009 expenditure will be $4.32 billion.

The states are looking for ways to reduce Medicaid costs. One idea being considered is to use a relatively unknown provision which is already on the books in 30 states. Called filial responsibility laws, these laws would obligate adult children to provide food, clothing, housing and medical attention for their indigent parents.

The definition of indigent will vary from state to state but a parent's need for assistance from a Medicaid program may be enough to support the definition of indigent. 21 of the states that already have filial responsibility laws on the books would allow a civil action to be brought by the state to obtain financial support for elder parents and get cost reimbursement.
Of particular concern should be the fact that in 12 states criminal penalties can be imposed and in 3 states both criminal and civil actions can be brought.

Most of these laws do exempt children who are not able to pay. However, the definition of what is considered in making the determination of ability to pay varies by state.
The state that currently have filial responsibility laws on the books are Alaska, Arkansas, California, Connecticut, Delaware, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Mississippi, Montana, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia.

Sheila Guilloton is the owner of Prestige Planners, a health specialty agency placing health and dental insurance for business and individuals. Licensed with all the major carriers, she counsels and advises clients on how to select the most appropriate coverage. To learn more about health insurance, health care reform and health issues visit


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