Tightening rules on asset transfers could save between $1 billion and $2 billion over five years, out of projected Medicaid spending for long-term care of $290 billion, Senate Finance Committee Chair Chuck Grassley (R-IA) said this week.

Sharpening restrictions on asset transferring was the focus of Thursday’s committee hearing. The committee conducted a two-day hearing this week on ways to improve Medicaid. Asset transferring occurs when elderly patients shift assets to family members to gain access to Medicaid-funding nursing home care.

The Bush administration has proposed making the transfers more difficult to execute. While the National Governors Association endorses Bush’s proposal, governors also favor a less punitive approach. They generally prefer to use untapped home equity, currently excluded from Medicaid calculations, to help pay for nursing home care. They also espouse widespread use of long-term care insurance.