Providing the financial resources for care of the elderly at assisted living facilities who cannot pay their own expenses could rest on the shoulders of their adult children.
The Center for Long-Term Care Financing estimates that one-third of Medicaid long-term care costs, $20 billion annually, are paid to provide
residencies for those who are indigent.
More than half of the states in the US have filial responsibility statutes that can require adult children to pay for their parents care themselves, rather than the state, and the National Center for Policy Analysis argues that keeping the responsibility within the family is fair under those rules.
In a position paper, the NCPA writes that "some middle income Americans are essentially using Medicaid as an inheritance protection plan," by having their parents transferring funds to them prior to an assessment for financial need.
In the 21 states where civil action is a possibility, the NCPA says that enforcing laws already on the books may lead to adult children and their aging parents plan for the financial costs of assisted living care.