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Affordable Care ActThe Impact on Special Needs Trusts

On March 23, 2010, President Obama signed the Affordable Care Act (ACA). The law puts in place comprehensive health insurance reforms that will roll out over four years and beyond.

The ACA removes lifetime limits on health benefits and creates new coverage options for individuals with pre-existing conditions.

Colorado later approved Medicaid Expansion for individuals under 65 years of age with income below 133 percent of the federal poverty level (Approximately $15,000 for an individual), which began January 2014. There is currently no asset test for this program.

What is NOT changing with the implementation of the ACA? (Why a Trust is still needed)

The Medicaid Waiver Program will remain the only real benefit program that will cover significant custodial home care services for people with disabilities.

Long-term care in Assisted Living Facilities and Nursing Facilities will still be paid by Medicaid when an individual does not have Long-Term Care Insurance, or income/resources to privately pay.

Supplemental Security Income (SSI) will continue to have a resource limit of $2,000 for individuals.

When a Trust May Not Be Needed

When an individual who meets the income requirements for Medicaid Expansion and does NOT need Long-Term Care or a Waiver program receives a windfall (PI Settlement, Back-payment in SSA, Inheritance), as there is no asset test for the Medicaid Expansion Service.

Individuals need to evaluate their eligibility for other programs such as LEAP, Food Stamps, etc.

Individuals need to evaluate the other benefits of placing funds in a Special Needs Trust, like:
- Budgeting – CFPD provides a plan for spending or saving to reflect your goals
- Protection from exploitation.
- CFPD provides a link to a network of community partners and resources.

So what are my next steps?

Consult with an attorney who is well-versed in the Affordable Care Act.

Call CFPD to discuss your individual situation. Our staff have been trained in the ACA and follow the implementation of new services and the impact of SNTs.