What is the Effect of DRA ’05

First, the CURRENT CALIFORNIA eligibility rules for LTC Medi-Cal can be easily found at
http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_limits.htm
where the list is for a married couple. The Well Spouse can own $120,900 as the CSRA/Community Spouse Resource Allowance and choose either the Name-On-The-Check (where each spouse keeps their own income) or choose the Joint Income Rule (to receive the $3,023/month MMMNA/Minimum Monthly Maintenance Need Allowance) to live at home while the Ill Spouse is at a SNF/Skilled Nursing Facility or ALF-W/Assisted Living Facility-Waiver.  (What is ‘waived’ is the requirement of 24/7 medical care with on-duty nursing staff being present.)

You should be able to locate the LTC Medi-Cal application office in all 58 California Counties at http://www.dhs.ca.gov/mcs/medi-calhome/CountyListing1.htm

Second, the federal DEFICENT REDUCTION ACT of 2005 (aka “DRA ’05”) was signed by President Bush on 2/8/2006. The purpose of this Act was to reduce the federal deficit. To many, this sounded like a good idea. However, Chapters 2 and 3 of this Act radically change the eligibility rules for seniors and disabled persons for Medic-Aid. This Act is adversely affecting the Eligibility of seniors and disabled residing in other states, other than California.

Third, at the present time, these changes are NOT yet affecting California residents, where the program is called “Medi-Cal”. California has long been more generous, in its Medi-Cal program, than the federal Medic-Aid program’s limits, which is a partial reimbursement for the California Medi-Cal outflows for care. For example, Californians have been allowed larger CSRA and MMMNA limits, more generous calculations for additional assets, and a shorter look-back period. At the coverage level, California has provided more care than other states, too. All of these statements can be supported by the federal GAO statistics and the Governors’ comparisons with each other, at their Governors’ Conference. And because of the coming wave of Baby-Boomers, those in charge have been comparing numbers, though sometimes not for the same elements.

While California is not yet operating under the DRA ’05 rules, it is possible that moving a Senior or Disabled Person from California to another state which is operating under the more limited federal rules could create unintended consequences: Ineligibility there in the other state, despite Eligibility here in California.  So if you are planning a move, please first check out the receiving state’s rules to ensure that all will be as you wish.