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Kegel v. State3/5/1992
the beneficiaries to avoid the "trap" of being too well-off to qualify for Medicaid, yet too poor to pay for the costs of necessary care. We do not believe that Congress drafted Section 1396a(k) to reach such transactions.
We hold that the trust fund is not within the express or implied intent of Congress in enacting Section 1396a(k)(2). We conclude that, under Section 1396a(k)(2), it is not a Medicaid qualifying trust. See Philbrook, 421 U.S. at 719; Miller, 746 F. Supp. at 33.
IV. CONCLUSION.
The Department's decision to terminate Eric's benefits appears to have been based solely on the trust's availability as a Medicaid qualifying trust. We do not discuss its availability other than under Section 1396a(k). Cf. In re Welfare of K.S., 427 N.W.2d at 659 (court relied on state statutes and rules specifying examples of personal property to be included as well as exempt in determining eligibility and on state rule that "'local agency must consider as available an asset that a person receives in a tort settlement, whether the settlement is entered into by the person or the person's guardian, that is structured to be paid over a period of time.'") (quoting Minn. Rule 9505.0061 (1987)). We do note that under the terms of the trust, the conservator has limited discretion in making any distributions to Eric. See Miller, 746 F. Supp. at 26-27 (discussing various state court rulings on the availability of trust funds in determining medical eligibility).
Section 1396a(k) does not authorize the Department's exclusion of Eric from eligibility for health care benefits. Therefore, the exclusion was contrary to law. See Philbrook. We reverse with directions for the Department to authorize benefits for him. See NMSA 1978, ยง 27-3-4(F)(3) (Repl. Pamp. 1989).
IT IS SO ORDERED.
DONNELLY and FLORES, JJ., concur.
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