You may be surprised to learn that in 30 states, including California, there’s a law on the books that declares adult children have a duty to pay for care for their impoverished parents.
Filial responsibility statutes, as they are called, require an adult child to reimburse state programs or institutions that have provided food, clothing, shelter and medical attention for their parents who no longer have enough funds to pay for themselves.
The statutes have a long history, dating back to England in the 1600s. They were adopted by the American colonies. In those times, they put into law what was considered a moral duty—that blood relatives take responsibility for supporting family members, including aging parents.
In the 1930s, Social Security arrived, providing income for the majority of seniors in retirement. And in 1965, Medicare came along, with the intention of giving every senior access to medical treatment and preventing them from using up all their savings in the process.
With the advent of those two programs, filial responsibility statutes were largely abandoned, although most remained on the books. Only one state, Pennsylvania, allows nursing homes to go after families to pay for nursing home bills or to complete Medicaid applications for their parents so that the state can pay the nursing home bills.
The case of Pittas v. HCR Manorcare went all the way to the Pennsylvania Superior Court and in 2012 held John Pittas, an adult son, liable for his mother’s $93,000 nursing home bill.
Today, Medicaid (a social healthcare program intended for low-income individuals) pays about 43 percent of long-term care costs in this country, according to a Kaiser Commission Study. That number is expected to grow dramatically as baby boomers who haven’t adequately prepared for old age retire, resulting in fewer seniors with the means to pay for often costly care.
Additionally, in advance of their need for long-term care, some middle-class seniors are transferring ownership of their assets to their children via trusts to become eligible for Medicaid without jeopardizing their children’s inheritance. A senior can give away an unlimited amount of assets to their adult children if they do so more than five years before Medicaid enrollment.
All this has some folks talking about bringing back filial responsibility laws in order to reduce government costs.
As long ago as 1983, the Health Care Financing Administration, a federal agency now known as the Centers for Medicare & Medicaid Services, estimated that nationwide enforcement of the state filial responsibility statutes could reduce Medicare spending by $25 million.
That number is probably in the billions today.
So what can adult children do?
Talk with parents about planning for long-term-care needs— the earlier the better. There are limited options when parents are in their 80s, but many more when they are in their 60s.
These conversations should include financial issues, such as knowing how much money might be needed, and potential options to pay for the care.
Those options include personal savings, life insurance and combo policies, annuity/long-term-care policies, longevity insurance, FHA reverse mortgages (HECMs), life care funding, VA benefits, Medicaid benefits, home equity options and health savings accounts.
Many options involve complex financial transactions, so consulting with an unbiased financial expert is infinitely helpful. Senior Concerns offers pro bono consultations with certified financial planners through our Financial Concerns program. To make an appointment, call (805) 497-0189.
These conversations are also about wishes and practicalities: Who will provide personal care for an aging parent when they can no longer care for themselves? Where will they live if they can no longer live safely in their own home? What will happen if they become cognitively impaired? What are their feelings on hospice and palliative care?
Even with the closest families, it’s not easy to have these conversations, let alone if you are estranged from a parent, if brothers and sisters aren’t talking, if stepbrothers and stepsisters exist or if you are financially struggling yourself.
If you are unable to have these conversations with your parents, begin to plan for yourself.
Planning for long-term care is everyone’s business.