U.S. District Court Judge Charles R. Richey ruled yesterday that Virginia and 14 other states have illegally forced spouses of aged, blind and disabled people in institutions to pay for part of their support.
Richey, ruling in a suit brought by an senior citizens group known as the Gray Panthers, ordered the states to stop using arbitrary guidelines under which spouses have been required to help support their institutionalized spouses regardless of the couple's financial condition.
Richey said federal law clearly states that when the federal government determines a person's eligiblity for Medicaid payments -- federal grants for medical services to indigents -- it should consider only money that is "actually available" to the institutionalized person.
The 15 states have adopted the debated procedure as one way of cutting Medicaid costs. Costs that are picked up by noninstitutionalized person would not have to be covered by Medicaid payments from the states.
Stephen Allen, an attorney for the National Senior Citizens Law Center, said that between 25,000 and 50,000 aged, blind or disabled people are affected by Richey's ruling. "Basically, elderly people will be released from an obligation they can't meet based on an arbitrary formula," he said.
Allen said the worst example of a state government forcing payments from noninstitutionalized spouses is occurring in Mississippi, where such people are forced to pay everything they earned over $78 each month.
The lawyer said that 35 states and the District of Columbia have regulations under which the use of the noninstitutionalized spouse's income is required only for the first six months after the spouse is admitted to a nursing home or other institution.
Richey said the legislative history of the Medicaid law shows that Congress did not intend for states to be able to assess a spouse for the cost of a husband's or wife's care.
"By applying an arbitrary formula, unrelated to the expenses of a particular couple's needs, deeming (that there is money for supporting a spouse) may well result in states assuming the availability of income which may not, in fact, be available," Richey said.