HHS Provides Guidance To State Medicaid Agencies For Same-Sex Couples

HHS Centers for Medicare & Medicaid Services (CMS) released guidance last week to state Medicaid agencies clarifying that they are able to offer same-sex couples many of the same financial and asset protections available to opposite-sex couples when a partner is entering a nursing home or care facility.  The letter advises state agencies of their ability to ensure that same-sex partners can remain in shared homes without Medicaid liens being applied and that states have the flexibility to protect same-sex partners under estate recovery and transfer of assets rules.

“Low-income same-sex couples are too often denied equal treatment and the protections offered to other families in their greatest times of need,” said Health and Human Services Secretary Kathleen Sebelius. “This is now changing. Today’s guidance represents another important step toward ensuring that the rights and dignity of every American are respected by their government. ”

The announcement clarifies that states can extend the same protections when the same-sex spouse or domestic partner of the Medicaid enrollee continues to reside in their home and outlines how states can apply other protections to same-sex spouses or domestic partners.  For example, these protections allow for individuals needing institutional care to transfer ownership of their homes without financial penalties. States have the choice of extending these protections.


“Medicaid gives states remarkable flexibility to set these kinds of policies,” said Cindy Mann, deputy administrator of the Centers for Medicare & Medicaid Services (CMS) who directs the Medicaid division within the agency.  “We want to assure states that they are within the law when they make the choice to extend equal financial rights and protections to all of their citizens receiving Medicaid services, regardless of sexual orientation.”