After reading some more about the program:
-States have had the
option to recover
some Medicaid costs on 65 or older recipients since the program began in 1965.
-93 omnibus bill changed the program from being opt-in to mandatory, the target age was dropped to 55, and the recovery options were expanded to seek recovery for any medicaid cost.
-25 states still stick to the original long-term care provision.
-25 states go after additional expenses as well as the original.
-Each state has their own rules and ways to avoid it completely before it kicks in.
-Some states ignored the program with Michigan being the final hold out until 2007 when they were threatened with losing all medicaid funding if they didn't create a program.
-There was a bill (H.R.6698 - Stop Unfair Medicaid Recoveries Act of 2022) that was introduced in 2022 to prohibit the use of estate recovery but it died in committee.
https://www.congress.gov/bill/117th-congress/house-bill/6698/text - It had some good cosponsors at least, so there's some people trying to do something.
There's been a push from elder advocacy groups to get legislation passed to kill this program completely. Some states have even passed legislation already to restrict what can be recovered, which is good, but this needs to be killed at the federal level.