Deficit Reduction Act S 1932 and State Filial Responsibility Laws

 

March 9, 2006

 

Dear Representative Moran:

 

I understand, from looking at Thomas on the Library of Congress website, that S. 1932, the Deficit Reduction Act of 2005, passed both houses of Congress and apparently was signed into law. I noticed that Section 6011 lengthened the look-back period and changed the beginning date for the ineligibility period in many situations relative to Medicaid-paid nursing home stays where beneficiaries have transferred assets to intended heirs in many situations.

 

Of course, most of us agree that nursing home patients should not be allowed to transfer assets to relatives just to “spend down” and be eligible for Medicaid. (I recall that this issue came up even in the late 1970s when I was working for Bradford on New York State Medicaid MMIS computer systems.) However, some commentators have suggested that S 1932 will result in nursing homes suddenly being flooded with non-paying patients and with the thirty states that have “filial responsibility laws” enacting massive litigation against unprepared adult children. Virginia is one of these states. Can you comment on whether this really likely to happen?

 

Looking deeper into this, I see a slow undercurrent of conservative pressure for states to enact and enforce filial responsibility laws in all situations, not just asset transfers. They would see this as a way to force the sharing of family responsibility and reinforcing nuclear family values. It does not take too much imagination to see how this could affect many gay and lesbian persons. Social conservatives could press for the view that every adult should be able to support and provide others in order to force non-conforming people to compete like “normal people” – a social model that encourages a lot of superficiality and hucksterism.  At the same time, these conservatives want, in a circular fashion, to deny gays and lesbians not only same-sex marriage but custody and adoption rights but even (as in Virginia) many domestic partner benefits that would fit the “civil union” model in some states, an paradigm that I certainly support as a practical measure. This sets up a circular “Catch 22” that is fundamentally like what would happen if Congress ever tried to restore the military draft while keeping “don’t ask don’t tell.”

 

I do look forward to your comments on this law.

 

Thank you.

 

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