In the Deficit Reduction Act of 2005, Congress tightened Medicaid asset transfer rules for individuals qualifying for Medicaid assistance with nursing home bills. Research on asset transfer shows a low incidence of asset transfers and limited cost savings from tightening such rules. But, because of demographic trends that will increase pressure on Medicaid and concerns that the Medicaid program may be financing care for higher-income beneficiaries when limited dollars should be spent on those with the most financial need, tightening Medicaid asset transfer rules remain a focus of policy efforts to reduce spending growth on Medicaid long-term care services.

The themes emerging from a series of interviews in six states with public long-term care benefit counselors at the state and local level are:

• Most people have not planned for their long-term care needs and are unaware of their options,

• Private long-term care insurance is too expensive for low and middle-income families, and

• Personal resources and family care-giving play important roles in providing long-term care services, but have limits.

 Report (.pdf)