New Hampshire, like many states, is moving toward tightening its policies regarding the relationship of asset transfers and Medicaid eligibility.
Here's a report from the Concord Monitor regarding yesterday's action in the Legislature:
The bill would expand the time the state can review certain assets in determining a person's eligibility for Medicaid. If a Medicaid applicant makes a gift within that time, he or she would not immediately qualify for assistance. A gift of money or investments would affect eligibility if it occurred within five years of applying for Medicaid. If the gift was real estate or a contribution to a trust, the "lookback" period would extend to 10 years. Currently, those windows are three and five years, respectively. Even with lawmakers' support, extending the lookback periods will require federal approval. The plan also would allow people to protect their assets if they have a qualifying policy for long term care insurance.
This is an issue everywhere and it sometimes cuts politically in unconventional ways. "Liberals" want to protect Medicaid's original purpose and "conservatives" want to reduce the costs of Medicaid. That may be leading to an emerging concensus for more restrictions.
However, to the degree that it's Republican constituencies that have assets worth protecting, there's considerable potential for political missteps here.
Years ago when I staffed health and welfare issues for the Committee on Ways & Means in the New York State Assembly, it was two quite conservative Republican members of the Assembly who absolutely pummeled me for presenting and arguing on behalf of a more rigorous asset test for Medicaid eligibility. One of them used their mother-in-law and the other their own mother as the prime examples. In other words, they would have been the ones who would have benefited from the estates to be passed on while Medicaid paid the nursing home bills. The same was likely true for their supporters.
Ever since, I've been careful not to assume what position people would take on this based on party affiliation or political philosophy.