Federal spousal impoverishment protections were set to lapse in March 2019. Two bills were proposed to deal with that issue. H.R. 1343 is still sitting in the House, but H.R. 3253 was enacted on August 6, 2019.

H.R. 1343, or the Protecting Married Seniors from Impoverishment Act, would have made certain impoverishment protections permanent. It was introduced on February 25th and referred to the Subcommittee on Health the next day, but no further action has been taken on it.

However, H.R. 3253 has been enacted. This bill, also known as the Empowering Beneficiaries, Ensuring Access, and Strengthening Accountability Act of 2019, temporarily extends the applicability of Medi-Cal eligibility criteria that protect against spousal impoverishment for recipients of home and community-based services. The extension will run through 2024. The bill also expands the purview of state Medi-Cal fraud control units, reduces requirements regarding the average manufacturer price (AMP or blended AMP) for drug manufacturers under the Medi-Cal Drug Rebate Program, and increases funding for the Medi-Cal Improvement Fund.

The Centers for Medicare & Medi-Cal Services (CMS) released the federal guidelines for how much money the spouses of institutionalized Medi-Cal recipients may keep. The minimum “community spouse resource allowance” a state may set is $25,284. The spouse of a Medi-Cal recipient living in a nursing home (the community spouse, in other words) may keep as much as $126,420 without jeopardizing their spouse’s Medi-Cal eligibility, and perhaps even more if there is a hearing or court order. These numbers will increase in 2020.

We help seniors and their loved ones access Medi-Cal benefits for long term care when appropriate. If you have questions about Medi-Cal eligibility or about programs you may be eligible for, please contact our San Diego office by calling (760) 642-7072.

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