Understanding Medi-Cal’s Asset Test for Seniors and People with Disabilities

Felicia Y. Sze, Founding Partner, Athene Law


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California’s Medicaid program, Medi-Cal, provides health coverage to people with low incomes, including children, families, many low-wage workers, seniors, and persons with disabilities. In addition to income, one of the factors considered in determining eligibility for California’s seniors and persons with disabilities is whether they have assets, such as savings, worth more than a specified amount. The purpose of this “asset test” is to limit access to Medicaid to only those who do not have access to sufficient resources to pay for their own medical care. The idea is that if people have substantial assets, they could use those to pay for the care they need.

However, the continued application of an asset test for seniors and persons with disabilities stands in stark contrast to the way eligibility is determined for many other populations who are eligible for Medi-Cal under the Affordable Care Act. This disparity in treatment has heightened concerns about the potential adverse impact of asset testing on seniors and persons with disabilities, many of whom have a fixed level of savings, are not employed, and are more likely than other populations to have high medical costs. In addition, members of these groups who are eligible for Medi-Cal may be deterred from enrolling by the specter of an onerous asset test or the risk of losing their modest financial safety net.

This issue brief describes:

  • Asset test rules California currently uses to determine Medi-Cal eligibility for seniors and persons with disabilities
  • The federal authorization that allows states to apply less restrictive resource limitations
  • How other states have used these authorities to adopt less restrictive asset limits
  • Questions California may choose to consider as it examines its current policy on asset tests for people applying for Medi-Cal

Note: The original version of this report contained an error. Endnote 20 has been corrected as of 5/2/2019.