NAELA Urges Legislative Changes to Eliminate Harmful Medicaid Estate Recovery Practices

On January 7, 2026, the National Academy of Elder Law Attorneys (NAELA) called for urgent legislative action to terminate the practice known as Medicaid estate recovery. This call comes as part of their ongoing mission to enhance legal services for elderly populations and individuals with disabilities. The proposed legislation, known as the Stop Unfair Medicaid Recoveries Act, was reintroduced in Congress by Representative Jan Schakowsky, aimed to halt the federal mandate that compels states to reclaim costs from the estates of Medicaid beneficiaries posthumously.

The federal government currently requires states to seek reimbursement for the long-term care services provided under Medicaid. This includes nursing home care, community-based services, hospital stays, and prescribed medications. A notable and troubling aspect of this policy is that when applying for Medicaid, a beneficiary's primary residence is generally not factored into the asset limit, which typically caps at $2,000. This means that the family home becomes the primary asset subject to recovery claims when an individual dies after receiving Medicaid services. Consequently, family members are at risk of losing their homes, casting a shadow over their dreams of homeownership and financial stability.

The Facts Behind Medicaid Estate Recovery

1. Unique Nature of Medicaid: Medicaid is the only federal program that requires post-death repayment for services rendered, placing an extraordinary financial burden on grieving families.
2. Marginal Returns on Investment: According to fiscal data collected in 2019, states managed to recover only between 0.1% and 1% of their overall Medicaid expenditures. This indicates an inefficiency in collecting funds that burdens individuals and families.
3. Disproportionate Impact: The practice disproportionately affects low-income families, particularly minorities and those with disabilities, who have long faced challenges in achieving homeownership. This recovery process creates an additional barrier, making it even harder for these communities to retain generational wealth.
4. Middle-Class Struggles: Individuals who once enjoyed middle-class stability may find themselves financially devastated by the medical expenses associated with aging or health complications, leaving nothing to pass on to their heirs.

Eric Einhart, the President of NAELA, expressed the sentiment aptly, stating, "Medicaid is the only federal program that sends an invoice to the grieving. Our members serve families who have adhered to guidelines, only to discover that government assistance often comes with strings attached, jeopardizing their family's future. We commend Representative Schakowsky for advocating against this harmful practice, ensuring that individuals should not have to choose between receiving necessary healthcare and keeping their family home for future generations."

The stories of those affected paint a vivid picture of the emotional and financial toll that Medicaid Estate Recovery has on families. Many have shared personal experiences that illustrate the profound stress and anxiety tied to financial insecurity—especially when their family homes are at stake.

To gain a deeper understanding of Medicaid Estate Recovery and hear firsthand accounts from individuals impacted by these policies, visit the NAELA Foundation's dedicated webpage.

About NAELA

The National Academy of Elder Law Attorneys (NAELA) stands at the forefront of advocating for quality legal services for older adults and people with disabilities. With over 4,000 members and 33 active state chapters, NAELA is committed to empowering elder law and special needs attorneys by providing the education, advocacy, and resources necessary to support their clients effectively. For more information, visit NAELA.org.

In conclusion, as the discussion surrounding Medicaid estate recovery continues, it is vital to underline the urgent need for legislative reform. The stories of families facing the potential loss of their homes must resonate with lawmakers as they ponder the ethical implications of end-of-life healthcare policies. By advocating for legislative changes, organizations like NAELA strive to protect vulnerable populations while fostering a more equitable approach to healthcare and property rights in the United States.