The Role of Estate Recovery in Medicaid Long-term Care: Perspectives of Older Adult Homeowners

Abstract

This qualitative study of older homeowners explored their perspectives on the estate recovery provisions that Medicaid recipients are required to accept if they depend on the program for their long-term care. Fifty-one homeowners age 55 and older who resided in a Midwestern metropolitan area participated in focus group discussions. Six groups were held at a large university medical center and attracted White participants (n=37) almost exclusively. Two groups were conducted at an urban senior center with African-Americans (n=14) participants. Findings that emerged from analysis of focus group data suggest that (1) participants viewed homeownership as conferring many social, psychological, economic and health benefits (2) participants had little information about Medicaid estate recovery (3) Medicaid was viewed as a necessary "safety net" to be used as a "last resort" and (4) support and non-support of estate recovery policy and the importance of inheritance varied greatly by research venue and, therefore, by racial composition of the focus groups. Implications for social work practice, policy and research are discussed with special attention to the complex dynamics of age, race, and asset building.