Did New York's 2014 Medicaid expansion change anything for senior long-term care eligibility?
Short answer: No — New York's 2014 ACA Medicaid expansion (and its earlier 2001 Family Health Plus expansion) covers non-elderly low-income adults. Long-term-care Medicaid for seniors uses entirely separate aged/blind/disabled eligibility rules that were not changed by either expansion.
It's an easy mix-up because "Medicaid expansion" gets used loosely in general conversation, but the eligibility pathway that pays for a Buffalo-area nursing home stay or an ALP placement for a 70-year-old is not the same pathway as the ACA expansion population. New York actually expanded Medicaid to low-income adults twice before most people think of as "Medicaid expansion" happening nationally — first through Family Health Plus starting in 2001, then again through the ACA's optional expansion effective January 1, 2014. Neither of those changed the separate aged/blind/disabled Medicaid rules — with their own income limits, asset limits, and spend-down mechanics — that actually govern senior long-term care eligibility.
