Abstract
The Medicaid Estate Recovery Program (MERP) is a federal mandate requiring states to recover costs of long-term care and related services provided to Medicaid beneficiaries from their estates after death. This Article explores the core arguments supporting and opposing MERP, offering a balanced analysis of its ethical, legal, and economic dimensions. Proponents argue that estate recovery ensures fiscal responsibility by recouping taxpayer dollars and preventing wealth transfer from those who received public assistance to their heirs. Proponents contend that MERP upholds the principle that Medicaid is a need-based program and a payor of last resort. Conversely, critics argue that MERP disproportionately affects low-income families, with the potential to create significant financial hardship. This undermines the intent of Medicaid as a social safety net by burdening the heirs of economically vulnerable individuals. The program’s complexity and lack of transparency often leave beneficiaries unaware of its potential impact, creating financial hardship for families already grappling with the loss of a loved one. Further, critics assert that estate recovery contradicts public policy goals of reducing poverty and providing security for older adults. This Article critically evaluates these arguments, drawing on legal precedents, policy analysis, and empirical data to assess whether MERP aligns with Medicaid’ s broader objectives or necessitates reform to protect vulnerable populations from financial exploitation.
Repository Citation
Shilanka I. Lewis,
A Matter of Life and Death: Give Me All of Your Money and I'll Give You Healthcare,
109 Marq. L. Rev. 1105
(2026).
Available at: https://scholarship.law.marquette.edu/mulr/vol109/iss3/8