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In this 3rd post of 3 I discuss the potential impact of cuts to Medicaid being considered by Congress and the President.  Last week I explained that specific changes, such as imposing a work requirement, are directed towards Medicaid recipients receiving Medicaid health benefits.  They would not apply to those people receiving long term care benefits. Other changes, however, would reduce federal funding.  Because Medicaid is a combination federal and state funded program, cutting federal funds would likely affect all of Medicaid’s various programs in indirect ways.  Each state manages its own program so Medicaid changes would affect each one in different ways.   If federal funds are cut, however, states would need to react by either increasing their funding to replace lost federal funds or cutting benefits. For example, the bill just passed by the House of Representatives which now awaits Senate review would cut federal funding to states that have expanded their Medicaid programs and that provide Medicaid coverage to undocumented immigrants using state funds.  Federal funds could be reduced by 10% or more to states that don’t comply. Any reduction in funding is bound to have some overall effect.  If states don’t replace federal funds then they could try to reduce the number of Medicaid recipients by making

In my blog post last week, I began a discussion about the possible impact of cuts to Medicaid.  This past week the House of Representatives approved a bill that among other things, reduces the federal outlay for Medicaid by almost a billion dollars.  The bill now goes to the Senate where some changes will almost certainly be made in order to obtain the votes needed for passage.  So there is still a lot of uncertainty as to what a final bill would look like. Nevertheless, we can examine what is and is not in the House bill just passed.  As I stated last week, the Medicaid program includes many different benefits.  The proposed cuts appear to be focused on the health insurance Medicaid benefits. The Medicaid long term care programs do not appear to be directly affected by these changes. For example, the proposed changes would impose a work requirement.  This is the change that has probably received the most attention in the media.  Medicaid recipients would need to work at least 80 hours per month to be and then maintain eligibility.   This requirement would apply to people ages 19 to 64.  In some cases community service, attending school or participating in a work program could be substituted.  Certain people would also

With so many significant changes being proposed, some which have already occurred in the first months of the new Congress and presidential administration, a question I am increasingly being asked by clients and prospects who are or may in the future apply for Medicaid is, “will there even be Medicaid when I need it?” It is impossible to answer this question with any certainty since we are living in very uncertain times.  Nevertheless, there is a certain level of misunderstanding about what is being considered by Washington and what is not.  It is these misconceptions that I can address. As I always explain, Medicaid is not one single “monolithic” program.  It is a series of different programs under what I call a “Medicaid umbrella”.  Additionally, while Medicaid was created by federal law, it is administered on the state level.  The federal government assigns a sum of money to each state.  Each state also funds these programs with its own money.   So, in order to understand the impact of any proposed changes and cuts, we need to examine which Medicaid programs may be affected and how the state that you reside in funds its programs.

As I have written about frequently in this blog, many of Medicaid’s numbers are updated annually.  Most but not all are adjusted in lock step with Social Security’s cost of living adjustment (COLA), which is affected by the rate of inflation. One Medicaid number that doesn’t adjust with Social Security is the Medicaid penalty divisor.  That is the number by which any transfers for less than fair value are divided to calculate the penalty - or waiting period - for Medicaid benefits.  This time period begins when a Medicaid application is filed and the applicant has proven that he/she has met all the other Medicaid requirements.  In other words, Medicaid would be approved but for the transfer of assets.  The more money transferred, the longer the penalty. The divisor is supposed to represent the average cost of nursing home level care in the state.  Over time that number has increased as the cost of care continues to rise so it should somewhat correlate to the rate of inflation.  I cannot recall any year in which the cost of care actually decreased.  Yet, last month New Jersey announced the new divisor effective 4/1/2025 which has actually decreased by 8.5% from last year. Effective April 1, 2025 the Medicaid divisor has decreased from

In my blog post last week I began to answer a very common question, “How do I transfer title to a motor vehicle of a deceased owner?”  If the vehicle is part of the probate estate, then either Letters Testamentary (if there is a will) or Letters of Administration (when there isn’t a will) are necessary before an appointed representative can transfer title. There are, however, ways to dispose of a vehicle without the need to file anything with the Surrogate or probate court.  In order for this scenario to be possible, the title owner must set things up a certain way while still alive. Title to a motor vehicle may be held as co-owners by spouses or domestic partners.    In that case, when one owner dies the surviving owner must complete an affidavit which can be found on the NJ motor vehicle website and bring it to DMV with the title and certified copy of the death certificate to have new title issued in the sole surviving owner’s name. Alternatively, title can be designated as payable on death to a named beneficiary but, again, this must be established while the owner is alive.  A transfer on death form that can be found on the state

It’s a question that comes up often and early when discussing how to administer estates after someone dies.  In part it is because of the difficulties many of us have had at times figuring out New Jersey’s Motor Vehicle Services process.  The question is “How exactly do I dispose of a motor vehicle when the owner dies? The first step is to locate the title to the vehicle.  Without it you can’t transfer title at all.  If you can’t find the title then you’ll need to get replacement title from NJMVS.  But that requires the Owner - who is deceased - to request it.   So, what to do? If only the deceased owner’s name is listed on the title then the vehicle is part of the probate estate.  In order to obtain replacement title and then transfer title some paperwork will need to be filed with the Surrogate first.  The exact procedure depends on whether there is a Last Will or not and the size of the estate. If there is a will, the executor named in it must present the document to the Surrogate of the county where the person lived at the time of their death.  With the surrogate certificate showing the appointment, the executor can then sign over title