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Back to Section One | Back to Arts & Entertainment
posted Friday, June 17, 2011 - Volume 39 Issue 24
Obama will protect same-sex couples under Medicaid
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Obama will protect same-sex couples under Medicaid

by Mike Andrew - SGN Staff Writer

In a new set of federal guidelines announced June 10, the Obama administration said that states may offer protections to same-sex couples equal to those now enjoyed by married spouses when one partner receives long-term care under Medicaid.

Created in July 1965 under Title XIX of the federal Social Security Act, Medicaid is a state-administered and federally regulated healthcare program for low-income U.S. citizens.

Under previous Medicaid guidelines, an individual is eligible for benefits after he or she depletes almost all their assets. If a Medicaid beneficiary owns a home, a state could impose a lien on the home to offset Medicaid expenses.

However, federal law prohibits imposing this lien if the beneficiary is legally married and the spouse is still living in the home.

When one member of an opposite-sex couple applies for institutional care, Medicaid pools the couple's assets and allows the healthy spouse to retain up to about $110,000. Thus both partners in an opposite-sex marriage are at least somewhat protected from the consequences of a protracted illness.

The old rules would not protect unmarried partners living together, however, even if their circumstances were exactly the same as those of a married couple.

Individuals who are part of a same-sex couple must apply as 'single,' and the healthy partner is not entitled to any assets or property that remains in their partner's name.

As a result, the healthy partner can be left homeless and impoverished.

Under the new guidelines signed by Deputy Administrator of the Centers for Medicare & Medicaid Services Cindy Mann, states can offer the same protection to same-sex partners of Medicaid recipients.

'A state can have a policy or rule not to pursue liens when the same-sex spouse or domestic partner of the Medicaid beneficiary continues to lawfully reside in the home,' the guidance states.

In a statement, Health and Human Services Secretary Kathleen Sebelius expressed hope that the new federal guidelines would create a more equal situation for same-sex couples.

'Low-income same-sex couples are too often denied equal treatment and the protections offered to other families in their greatest times of need. That is now changing. Today's guidance represents another important step toward ensuring the rights and dignity of every American are respected by their government,' she said.

Since Medicaid is administered by the individual states, the new guidance from the federal government does not mandate states to provide protection to same-sex partners, but it does state that DOMA (the federal Defense of Marriage Act) does not preclude states from providing this protection.

According to the new guidelines, each state may 'incorporate their criteria for determining when to impose a lien in the Medicaid State plan,' with some states presumably protecting same-sex partners and others not.

Washington state law already prohibits the state's Department of Social and Health Services from filing a lien against the home of a Medicaid client if 'the client's spouse or domestic partner' still lives in the home.

The Obama administration had not previously taken a position on whether same-sex couples could receive these protections while DOMA remains on the books.

On February 23, Attorney General Eric Holder announced that President Obama had concluded that DOMA is unconstitutional, and that the Justice Department would no longer try to defend it in court, but would continue to enforce it until it is repealed by Congress.

The U.S. Department of Health and Human Services has been examining ways to offer more protections to same-sex couples under Medicaid as part of a general re-examination of federal policies by the Obama administration, but until now it had not issued policy guidance to states.

HRC spokesperson Michael Cole-Schwartz praised the Obama administration for issuing the guidance, but added that same-sex couples won't have equal protection under the law until DOMA is repealed.

'No one should have to choose between keeping their home and getting the medical care they need and deserve,' Cole-Schwartz said.

'This is an important step to give some couples the security and dignity they deserve when they need it most. However, all same-sex couples will remain vulnerable until we end discrimination in marriage and repeal the Defense of Marriage Act.'

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