The Affordable Care Act and Guardian Caregivers

According to the Congressional Research Office, “the primary goal of the Affordable Care Act is to increase access to affordable health insurance.”  For most of my clients the ACA has been a net positive. The non-insured spouse has the ability to obtain insurance on the open market at a price that is generally less than COBRA coverage, without worrying about the effect of pre-existing coverage. There is expanded coverage for Medicaid, which allows more children, disabled adults, and senior citizens to be insured.

Some of my clients may be affected by an odd provision in the Act that provides that it is a conflict of interest for the guardian of a disabled adult to be a paid caregiver.

Many of my clients rely on Medicaid waiver programs to fund services for their special needs Minnesota family lawyer member.  Often, these programs allow family members to be paid as caregivers. This program allows families the ability to provide care that might otherwise be provided by low-paid personal care attendants.  Personal care attendants are difficult to find, difficult to train, and difficult to retain.  The lack of available care places the special needs individual at risk of neglect.  Moreover, my clients tell me that they would rather provide the care for their family member than hire a stranger.

There are a number of fixes being proposed for this problem.  States that have accepted expanded Medicaid funding are attempting to accommodate Medicaid beneficiaries, but the proposed solutions at this point involved delegating the responsibility for creating a care plan to the State or a contracted care company.  That is problematic, since these waivered programs are designed to allow the individual and their families to decide how care will be provided. If a solution is not found to this problem, it is possible that family guardians will either have to give up the income they received from the waiver programs or be faced with the difficult and expensive process of transferring guardianship of their special needs adult to someone else.

About Author

Jennifer graduated from the University of Minnesota cum laude with a bachelor’s degree in speech communications. In 2006, Jennifer achieved her life’s dream; owning her own Family law attorney Minnesota practice. She practices every day as Divorce lawyers Minnesota with the intention of representing her clients’ future.