State Medicaid programs can extend financial protections to same-sex spouses in nursing homes

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The Centers for Medicare & Medicaid Services has sent a letter to state Medicaid programs clarifying the ability to offer same-sex couples the same protections opposite-sex couples receive when one partner needs facility-based long-term care.

Medicaid is the country's largest payer of nursing home services. When a Medicaid beneficiary is in a facility, his or her spouse or dependent child is allowed to stay in the family's home. While the state can place liens on the beneficiary's property, it cannot put a lien on the home. In the June 10 letter CMS gives states the authority to apply this same rule to same-sex couples. CMS also clarified that same-sex partners can be protected under estate recovery and transfer-of-asset rules.

The CMS letter also describes how states can apply other protections to same-sex spouses or domestic partners by allowing individuals needing institutional care to transfer ownership of their homes without financial penalties.

“Low-income same-sex couples are too often denied equal treatment and the protections offered to other families in their greatest times of need,” said Kathleen Sebelius, Secretary of Health and Human Services. “This is now changing. Today's guidance represents another important step toward ensuring that the rights and dignity of every American are respected by their government."

The move to adjust state laws for same-sex couples will become more common as more states pass laws allowing for civil unions and domestic partnerships. Illinois started authorizing civil unions on June 1, making it the most recent state to do so.