VA Pensions to Medicaid Nursing Home Residents Should Be Reduced
HRD-87-111, Jul 10, 1987
GAO reviewed how Veterans Administration (VA) and Medicaid benefits interact to determine: (1) how many medical nursing home residents are receiving VA pensions; (2) how states apply these pensions toward the cost of care; (3) the effect of VA pensions on state and federal costs; and (4) how other needs-based programs adjust benefits for institutionalized recipients.
GAO found that: (1) about 6 percent of the Medicaid nursing home residents in the eight states it reviewed received VA benefits; (2) each state required veterans to apply their VA pensions toward the cost of their care; (3) because the states applied the VA payments to the cost of care as part of the Medicaid recipient's income, the federal government paid a higher percentage of Medicaid nursing home costs for veterans with VA benefits than those with no income; and (4) all eight states instituted programs to maximize VA benefit collections on behalf of Medicaid nursing home residents, since the federal government pays about 71 percent of the cost.
- Closed - implemented
- Closed - not implemented
Matter for Congressional Consideration
Matter: Congress should amend title 38 to require that the VA pension for veterans and their survivors who enter a nursing home under Medicaid be reduced. One way would be to amend title 38 to extend the VA pension reduction criteria that currently apply when the recipient is institutionalized in a VA-supported facility to cover recipients supported by Medicaid. Alternately, the reduction could be tailored to the personal needs allowance established by each state Medicaid agency.
Status: Closed - Implemented
Comments: Committee staff supports this recommendation and will consider action during the cycle if the budget deficit worsens. Congress enacted the Omnibus Budget Reconciliation Act of 1990 (P.L. 101-508) which reduced VA pensions to $90 a month for veterans without dependents who receive Medicaid-supported nursing home care.