Witnesses tell House Medicaid Committee HB 318 would limit Medicaid estate recovery that can force older Ohioans from family homes

Proponents and affected residents told the House Medicaid Committee that Ohio's Medicaid estate-recovery program has saddled older Ohioans and their families with unexpected bills and threatened home loss, and they urged the committee to pass House Bill 318 to limit those recoveries.

Bob Weldon, speaking as a proponent, said he represents "thousands" of people age 55 and older who enrolled in Medicaid through the Affordable Care Act and later discovered estate-recovery claims against their estates. "The state of Ohio has failed in the last 11 and a half years to provide any meaningful notification," Weldon said, describing cases in which people were told by hotlines that their coverage was "not subject to recovery" when, Weldon said, it in fact was.

Erin Campbell, a staff attorney at Pro Seniors, described the consequences for families and communities. "Medicaid estate recovery is heartbreaking and financially devastating to families," Campbell said, detailing how homes often become the primary source of estate recovery and how survivors can be forced to leave a family home. Campbell said Pro Seniors supports HB 318 in full and highlighted specific provisions in the bill she and clients favor: a waiver of recovery when the expected recovery is below a dollar threshold (for example, a $20,000 cutoff discussed in testimony), prohibiting liens that exceed 75% of assessed property value, and limiting recovery to long-term nursing-home admissions or home- and community-based waiver services that meet federal Medicaid recovery requirements.

Campbell explained the federal baseline for estate recovery and cited the relevant federal statute by number: "42 U.S.C. § 1396p" is the federal law that requires a state to pursue certain estate recoveries to participate in Medicaid, she said, and Ohio's current practice goes beyond that minimum. She also described the state's fiscal return on recoveries as reported in a fiscal attachment: roughly "25 cents on the dollar," with allocation percentages she recited to the committee: about 10% to the attorney general, 20% to special counsel, about 45% to the federal government, and roughly 24.8% to the Ohio Department of Medicaid.

Several witnesses offered individual cases to illustrate the problem. Weldon pointed to examples included in the written record, and a witness identified as Eric Stocker described being told he could enroll in Medicaid and that it was "free," only to later learn that more than $90,000 in charges had been attributed in state records and roughly $70,000 of that related to the period after his spouse turned 55. Stocker said some agency employees told him the program was "free," and later he was told the state would pursue estate recovery. "I was told ... it's free, which was the first lie that I got," Stocker said.

Committee members asked several clarifying questions about how recovery amounts and collection costs are calculated and about the state's obligations under federal law. Representative Stevens and Ranking Member Baker both asked whether limiting state recovery beyond the federal minimum would jeopardize federal Medicaid funding; Campbell answered that Ohio may tailor its recovery to the federal requirement and that she was aware of no federal penalty so long as the state complies with the federal statute's baseline.

Witnesses urged the committee to consider provisions that would spare families from disproportionate hardship, such as dollar cutoffs, limiting recovery to probate estates for long-term care, and capping liens. No motion or vote on HB 318 was recorded during the hearing. The committee heard additional written testimony and moved on without taking action during the recorded session.