By Zichang Liu
Boston University News Service
Not long after state Sen. Jo Comerford took office in 2019, a constituent reached out for help after they received a bill from MassHealth in the wake of a family member’s death.
The state was seeking to recover expenses associated with caring for their loved one — a decades-long practice in which MassHealth aggressively followed federal law requiring state Medicaid programs to recover costs from the estates of deceased beneficiaries who received long-term services and supports in medical institutions or nursing homes after age 55, as well as from people expected to permanently reside in nursing homes.
The state often claimed family homes to recoup expenses, and did so at levels beyond the minimums set by federal law. Comerford’s office estimated that over 90% of these repayments to MassHealth came from forced sales of family homes.
Comerford said the family that contacted her was facing the possibility of having to sell their family home, where a relative still lived, just to pay for the expenses. The Northampton Democrat helped the family get a hardship waiver, but the effort fueled her commitment to changing the law.
Six years later, that effort has paid off.
Gov. Maura Healey last month signed long-term care legislation that includes a provision restricting Massachusetts’ estate recovery program to the federally set minimum. The new policy, sponsored by Comerford and state Rep. Christine Barber, D-Somerville, also rules out esta te recovery from residents receiving assistance under CommonHealth and personal care attendant services.
“We were going much farther in the state law than the federal government required,” Comerford said. “We were clawing back much more money from families.”
Previously, MassHealth was required by state law to seek reimbursement for the total cost of long-term care not only from recipients who turned 55 but also from clients of any age if they received long-term care services. This included the costs of hospital care, doctor’s care, prescription drugs, physical therapy, and any other services provided through MassHealth, Comerford said.
She described the law as “extraordinarily unfair,” revealing a chronic state problem that hurt families and people, perpetuating wealth inequality and disrupting families’ ability to break the cycle of intergenerational poverty.
Before the new law, MassHealth sought repayments if a deceased member’s estate was valued at over $25,000. Still, this threshold was itself a reform enacted since November 2020, aimed at protecting low-income people and eliminating approximately half the cases that were previously subjected to estate recovery.
But a report by the Blue Cross Blue Shield of Massachusetts Foundation in February stated that more still could be done.
“When that property is lost, it is often the end of intergenerational wealth, and this is how families pass things onto their children,” said state Rep. Lindsay Sabadosa, D-Northampton, another co-sponsor of the bill. “Not only were they losing their homes, but they were losing their investment.”
The latest U.S. census population estimate shows that older adults (age 65 and above) make up 19.7% of Hampshire County, higher than the 18.5% in Massachusetts. The data also shows that 25.2% of the county’s population is age 55 or older.
Sabadosa said the new law will be critical for the families that it affects each year.
“It is the difference between having your equity in your pocket so that you can start your life over and really starting over from scratch,” she said.
One strong advocate for the bill was Joe Tringali of Amherst, a 45-year member of the Stavros Center for Independent Living. Tringali, who died last December, was dedicated to advancing health care, personal care and housing accessibility. Comerford said he was unwavering in his dedication to ending MassHealth’s estate recovery program.
“I can’t begin to tell you how much the passage of this bill means to me,” said Kathy Edgell, Joe’s partner. “Joe worked so hard for it, and my life going forward will be much easier economically.”
“The passage of this bill is really a story of people making government work,” Comerford said.
This story originally appeared in the Daily Hampshire Gazette.
