November 14, 2024
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Court affirms state rules on Medicaid eligibility

WASHINGTON – The Supreme Court on Wednesday upheld the way Wisconsin and about 30 other states, including Maine, calculate Medicaid eligibility for nursing home residents. Justices ruled that states can use a formula that takes into account the incomes of a nursing home resident and a spouse who still lives at home.

The 6-3 decision is a defeat for nursing home residents such as 78-year-old Irene Blumer, who was turned down for government assistance. She argued that her 82-year-old husband, Burnett, would have to spend his savings before she could qualify for Medicaid. Wisconsin had argued that without the rules, couples could shelter assets.

The Supreme Court, in a decision written by Justice Ruth Bader Ginsburg, ruled that the state law does not conflict with a federal law designed to prevent spouses of nursing home residents from becoming paupers.

Under Maine’s Medicaid rules, a nursing home resident can qualify for Medicaid coverage if his or her spouse has no more than $89,000 in assets. Money above that threshold must be spent on care before Medicaid kicks in.


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