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Primary Submission Category: Policy

Asset Limits Continue To Restrict Medicaid Eligibility For Older Adults And People With Disabilities

Authors:  Andrew Anderson, Catherine Ettman,

Presenting Author: Catherine Ettman*

Research Objective: The Affordable Care Act and Medicaid expansion created new income-based eligibility pathways that lifted asset limits for some populations. However, individuals who qualify for Medicaid under the aged, blind, and disabled pathway remain subject to both income and asset tests. This bifurcated eligibility structure results in some income-eligible older adults and individuals with disabilities being excluded from Medicaid solely due to asset tests that are no longer applied to other groups.

 

Study Design: First, we documented income and asset limits across states using 2024 state-specific Medicaid eligibility websites and Medicaid planning assistance resource guides. Second, we used the 2023 American Community Survey and corroborated with previously published data to state-specific estimates of the aged, blind, and disabled population. We defined actual and potential Medicaid eligibility using state-specific income thresholds and assessed the number of individuals excluded solely due to asset tests.

 

Principal Findings: First, we identified variation in financial asset limits for Medicaid eligibility across states. The majority of states had asset limits at the federal guidance of $2,000. Connecticut had a lower asset limit ($1,600), and seven states (Illinois, Maine, Maryland, Minnesota, New York, Oklahoma, Rhode Island) had higher limits, ranging from $2,500 in Maryland to $31,175 in New York

For housing, 41 states used the federal home equity limit of $713,000. Idaho, Maine, and Wisconsin set home equity limits at $750,000, and six states (District of Columbia, Washington, New York, New Jersey, Hawaii, Massachusetts) applied the maximum allowable limit of $1,071,000. California eliminated asset limits for Medicaid eligibility in January 2024—the only state to do so.

We estimate that 18,164,352 older, blind, and disabled Americans were potentially subject to asset limits under 2024 Medicaid eligibility thresholds. Among those adults, 8,598,582 may have met income criteria but were excluded from Medicaid eligibility solely due to asset tests.

 

Implications for Policy or Practice: Asset limits may create a disincentive to save and reduce financial stability among vulnerable populations. Estimating the number of income-eligible individuals excluded due to asset tests allows policymakers to assess the potential coverage gains and administrative simplification from reform. Asset limits may be a policy lever to adjust in efforts to improve access to care, reduce administrative burden for states and enrollees, and improve population health.