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 Hingham
- This month’s Legal Check Up is devoted to providing a
legislative update, as there has been significant activity
on several issues affecting elders and their families.
MassHealth Equality Bill
In the February Legal Check Up column, we discussed the
problems with long-term care planning for same-sex married
couples. While same-sex marriages are now legal in
Massachusetts, they are not recognized at the federal level
due to the federal Defense of Marriage Act (DOMA), which
defines marriage as a legal union between one man and one
woman for issues involving federal laws. DOMA also provides
that states do not have to recognize same-sex marriages, and
since MassHealth is funded through a combination of federal
and state funds, the Division of Medical Assistance (DMA)
has been relying on DOMA to deny same-sex married couples
the same protections that their heterosexual counterparts
enjoy. Advocacy efforts to force the DMA to follow the
Goodridge decision and recognize same-sex marriages for
MassHealth eligibility purposes have paid off.
On July 29th, the House of Representatives approved the
MassHealth Equality Bill (H- 4107), by voice vote and
without debate. The bill was sponsored by Rep. Elizabeth
Malia (D-Jamaica Plain). Following passage in the Senate,
the Governor signed it on July 31st. There is a customary
90-day waiting period before any change will be implemented
as a result of the Bill’s passage and there are still
questions as to whether the federal portion of MassHealth
funding will be affected by DOMA, despite this Bill’s
passage. Only time will tell and we will keep you posted.
Reverse Mortgage Improvements
The Senate passed a bill (HR 3221) that provides for
fundamental changes to HUD’s HECM (Home Equity Conversion
Mortgage) reverse mortgage program. The President is
expected to sign the bill into law within days but the
changes will not be implemented for up to 90 days, when HUD
issues a Mortgagee Letter formally activating the changes.
The most significant changes include:
• County by county lending limits will be replaced by one
nationwide lending limit of $417,000. In certain "high cost"
housing areas, that limit may be adjusted to as high as
$625,000. Homeowners in counties that presently have lower
lending limits (Bristol and Worcester, for example) will
benefit most from this change.
• The cap on the lender's financed origination fee will be
reduced to $6,000. It can presently be as high as $7,255.80.
• Lenders will be able to offer HECM for Home Purchase
products, for seniors who need funds for a home purchase.
• There will be greater protection for seniors through a
prohibition on requiring the purchase of annuities and other
financial products with reverse mortgage loan funds and
restrictions regarding cross-selling of financial products.
Nursing Home Admissions
Unfortunately, not all of the legislative activity has been
positive. Governor Patrick vetoed language in the Fiscal
Year 2009 Budget which would protect nursing home residents
from improper discharge due to a change in MassHealth
clinical criteria. Without this language in the Budget,
frail elderly residents are at risk of being improperly
discharged or denied admission.
MassHealth will currently pay for the cost of nursing home
residents who need a level of care known as “Score 3,” and
may only deny reimbursement for such residents if they could
obtain adequate, less expensive care in the community.
Inclusion of Score 3 protective language in the budget has
prevented previous attempts by MassHealth to require a
higher clinical level of care to qualify for nursing home
coverage.
This change could have catastrophic results for elders and
their families, who would have to struggle to provide care
in the community for many elders who would require nursing
home care under the present clinical criteria.
This change could affect you and your loved ones. Please
call your Representative and Senator today and ask them to
support an override of Governor Patrick’s veto.
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