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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsIs your spouse actually a member of your family? Not in Ohio, it would seem
https://www.toledoblade.com/Medical/2015/09/02/Court-rules-Ohio-spouses-are-eligible-for-Medicaid.html
In a decision that could have far-reaching effects, a federal appeals court ruled Tuesday that Ohio must count an applicants spouse as a member of his family when determining eligibility for financial assistance to pay Medicare bills.
A three-judge panel of the Cincinnati-based U.S. 6th Circuit Court of Appeals told the state it cant exclude a beneficiarys spouse when it comes to income calculations simply because the federal law doesnt define the word family.
At issue is a program under Medicaid, the federal-state insurance program for the poor, that helps low-income Ohioans pay their premiums, co-payments, and deductibles under Medicare, the federal health insurance for senior citizens.
The larger the family, the more a beneficiary may earn and be eligible for that financial help.
Ask 100 Americans whether a 74-year-old mans family includes his wife who lives with him, and every one of those Americans will likely say yes, 6th Circuit Judge Raymond M. Kethledge wrote. But the Ohio Department of Medicaid answered no, with the result that it denied Joe Turners application for benefits under the Medicaid Act.
It should have been clear to Ohio that the word family, as used in the provisions here, does not mean whatever the states officials want it to mean, but instead includes at least a beneficiarys resident spouse, Judge Kethledge wrote.
In a decision that could have far-reaching effects, a federal appeals court ruled Tuesday that Ohio must count an applicants spouse as a member of his family when determining eligibility for financial assistance to pay Medicare bills.
A three-judge panel of the Cincinnati-based U.S. 6th Circuit Court of Appeals told the state it cant exclude a beneficiarys spouse when it comes to income calculations simply because the federal law doesnt define the word family.
At issue is a program under Medicaid, the federal-state insurance program for the poor, that helps low-income Ohioans pay their premiums, co-payments, and deductibles under Medicare, the federal health insurance for senior citizens.
The larger the family, the more a beneficiary may earn and be eligible for that financial help.
Ask 100 Americans whether a 74-year-old mans family includes his wife who lives with him, and every one of those Americans will likely say yes, 6th Circuit Judge Raymond M. Kethledge wrote. But the Ohio Department of Medicaid answered no, with the result that it denied Joe Turners application for benefits under the Medicaid Act.
It should have been clear to Ohio that the word family, as used in the provisions here, does not mean whatever the states officials want it to mean, but instead includes at least a beneficiarys resident spouse, Judge Kethledge wrote.
Comment by Don McCanne of PNHP: What kind of bureaucrat would make a decision that Medicaid benefits can be denied to an applicant by arbitrarily declaring that the applicants spouse is not part of the family and thus the family is too small to qualify? Perhaps Ohios family-values Governor John Kasich could explain, if he werent so busy running for President.
The real lesson here is that we really need to question the wisdom behind the multitude of health reform proposals that would provide federal grants to states and allow them to craft their own health care financing policies. Its bad enough that states can refuse to participate in the Medicaid expansion, depriving millions of the health care that they should have. Just imagine the liberties they could take if allowed to make decisions such as redefining a family as having only one spouse when there are actually two.
Although a single payer system would be administered on a state or regional basis, the basic requirements would be established at the federal level. An example is the Canada Health Act which simply requires public administration, comprehensiveness, universality, portability and accessibility. Although their single payer systems are administered on the provincial level, there are no provinces that exclude a spouse from the definition of a family.
In the United States, it would not work to have federal legislation defining a national health program that is as simply stated as in the Canada Health Act. We have a track record of shameless gaming of the system to the detriment of patient care. Thats why we need greater specifications of the requirements - such as those in HR 676, the Expanded and Improved Medicare for All Act, by Rep. John Conyers with 51 cosponsors. We really cant turn the decisions over the bureaucrats in supposed family-values states who actually dont believe in family values.
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Is your spouse actually a member of your family? Not in Ohio, it would seem (Original Post)
eridani
Sep 2015
OP
riversedge
(70,218 posts)1. This applies to Red state Wisconsin......
............
The real lesson here is that we really need to question the wisdom behind the multitude of health reform proposals that would provide federal grants to states and allow them to craft their own health care financing policies.............
Walker is too busy campaigning to do anything about this. But I wonder if he would anyway--he uses it to claim ACA is a failure. damn him!
#ScottWalker Administrations Lax Health Insurance Regulation Costly for Wisconsin Consumers http://www.citizenactionwi.org/walker_administration_s_lax_health_insurance_regulation_costly_for_wisconsin_consumers via @CitizenActionWI
eridani
(51,907 posts)2. Yes. The Canadian system is run by the provinces, but they MUST conform--
--to strict national standards. Of course, ACA does leave openings for state single payer.
Recursion
(56,582 posts)3. Is Ohio commonlaw or community property?
IIRC this question is actually pretty thorny in terms of legal history and gets treated very differently in a lot of states.
eridani
(51,907 posts)4. I would think that either way, being married settles the issue of whether you are in the same--
--family or not. And with marriage equality, this is now true across the board.