Fed. court overturns Ohio Medicaid ruling on spouses

A federal appeals court ruled this week that Ohio must count an applicant’s spouse as a member of his family when determining eligibility for financial assistance to pay Medicare bills (Source: “Court rules Ohio spouses are eligible for Medicaid,” Toledo Blade, Sept. 2, 2015).

A three-judge panel of the Cincinnati-based U.S. 6th Circuit Court of Appeals told the state it can’t exclude a beneficiary’s spouse when it comes to income calculations simply because the federal law doesn’t define the word “family.”

At issue is a program under Medicaid that helps low-income Ohioans pay their premiums, co-payments, and deductibles under Medicare. The larger the family, the more a beneficiary may earn and be eligible for that financial help.

“Ask 100 Americans whether a 74-year-old man’s ‘family’ includes his wife who lives with him, and every one of those Americans will likely say yes,” 6th Circuit Judge Raymond M. Kethledge wrote. “But the Ohio Department of Medicaid answered no, with the result that it denied (an) application for benefits under the Medicaid Act.”