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• W304392908 abstract "Medicaid: States May Employ Income-First Method for Medicaid Eligibility-Wisconsin Department of Health & Family Services v. Blumer1-The U.S. Supreme Court held that neither the statutory language nor the structure of the Medicare Catastrophic Coverage Act of 1988 (MCCA)2 forbids the approach employed by a majority of states to determine Medicaid eligibility.3 Congress enacted the MCCA to prevent a non-institutionalized from being forced into poverty from the costs of caring for his or her institutionalized spouse.4 The community spouse retains a portion of the couple's assets, called the spouse resource allowance (CSRA),5 and is allocated a minimum monthly maintenance needs allowance (MMMNA).6 If the community spouse's falls below the MMMNA, he or she is allowed a spouse monthly allowance (CSMIA),7 an transfer from the institutionalized spouse to make up the shortfall.8 The couple is allowed a fair to challenge Medicaid eligibility9 and to request a higher CSRA.10 States have employed two methods in determining CSRA. Under the incomefirst method, spouse's income is defined to include the community spouse's at the time of the hearing, and also any potential post-eligibility transfer (CSMIA) from the institutionalized spouse. The second method, resources-first, excludes CSMIA from consideration. If the community spouse's falls below MMMNA, the resources-first method raises the CSRA to reserve additional assets. Respondent Irene Blumer entered a nursing home in 1994, and applied for Medicaid coverage two years later. Under Wisconsin's rules, her husband Burnett was entitled to keep one-half of the non-exempt assets the couple had in 1994, calculated at $72,822, plus a $2,000 allocation for his wife. In 1996, the couple's total assets were $89,335, but that figure still exceeded the maximum allowance. Burnett's own Social Security and annuity benefits did not meet his MMMNA, and he wished to raise the asset cap to make up the shortfall. Wisconsin regulations, however, required him to transfer from his wife first to meet the MMMNA level.11 The Circuit Court of Green County affirmed the hearing examiner's determination using the income-first method; however, the Court of Appeals reversed, concluding MCCA mandates the resources-first method.12 The parties argued that the definition of spouse's income goes to the issue of whether the Wisconsin statute conflicts with MCCA. Blumer maintained that spouse's income includes actually received by the community spouse at the time of the Medicaid hearing, not any anticipated post-- eligibility transfer from the institutionalized spouse.13 Blumer also argued that the design of the Act as a whole precluded the income-first method.14 Writing for the majority, Justice Ginsburg disagreed, noting that although the hearing is conducted before eligibility is determined, its purpose is to anticipate the post-eligibility financial situation of the couple.15 Ginsburg reasoned that the leeway for state choices is characteristic of the Medicaid statute, which is designed to advance cooperative federalism.16 Eliminating the income-first choice would hinder a state's efforts to strike its own balance in the implementation of MCCA. …" @default.
• W304392908 created "2016-06-24" @default.
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• W304392908 date "2002-01-01" @default.
• W304392908 modified "2023-09-24" @default.
• W304392908 title "Medicaid: States May Employ Income-First Method for Medicaid Eligibility-Wisconsin Department of Health & Family Services V. Blumer" @default.
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