{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T20:06:29Z","timestamp":1781381189858,"version":"3.54.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009239","name":"Horowitz Foundation for Social Policy","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009239","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>Medicaid look-back periods are meant to prevent Medicaid applicants from gifting assets to meet eligibility requirements. These policies have the potential to affect families across generations given their ability to restrict the transfer of assets between parent and child.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research Design and Methods<\/jats:title>\n                  <jats:p>Using 2008\u20132018 data from the Health and Retirement Study, this study analyzed the estate planning and familial wealth transfer behaviors of a cohort of older adults aged 65 and older who became Medicaid recipients during a 10-year period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 8,347 respondents aged 65 and older in 2008 and 11.96% of respondents who were not Medicaid recipients at baseline became recipients over the study period. A little more than one third (36.47%) of Medicaid recipients participated in estate planning and asset transfer prior to becoming a recipient, with significant differences among select demographic characteristics. Married recipients were more likely to transfer money compared to their widowed counterparts (51.69% compared to 36.44%; p &amp;lt; .001) and transferred larger amounts compared to those unmarried ($16,286.94 compared to 5,379.13). White, well-educated, married, men participated in higher rates of estate planning, likely a reflection of who has access to resources to make necessary arrangements early.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Implications<\/jats:title>\n                  <jats:p>This analysis concludes that more structurally advantaged groups are more likely to engage in estate planning prior to Medicaid enrollment. This analysis demonstrates that some individuals may circumvent Medicaid policies like look-back periods and estate recovery, while others cannot. Policymakers should consider policies that promote the financial health of low-income families.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geront\/gnae074","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T05:27:39Z","timestamp":1718083659000},"source":"Crossref","is-referenced-by-count":4,"title":["Medicaid Enrollment and Intergenerational Transfers of Wealth Among Older Adults"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7396-261X","authenticated-orcid":false,"given":"Amanda","family":"Spishak-Thomas","sequence":"first","affiliation":[{"name":"Rutgers Center for State Health Policy, Institute for Health, Health Care Policy and Aging Research , New Brunswick, New Jersey , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"issue":"6","key":"2024070410204384100_CIT0001","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1093\/geront\/gnab189","article-title":"Effects of the 2014 Affordable Care Act Medicaid expansions on health care access and health status of poor adults aged 60\u201364 years: Evidence from the first 6 years","volume":"62","author":"Bin Abdul Baten","year":"2022","journal-title":"Gerontologist"},{"issue":"1","key":"2024070410204384100_CIT0002","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1539-6975.2009.01286.x","article-title":"The private market for long-term care insurance in the United States: A review of the evidence","volume":"76","author":"Brown","year":"2009","journal-title":"Journal of Risk and Insurance"},{"issue":"3","key":"2024070410204384100_CIT0003","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1177\/0022146512455427","article-title":"The social stratification of older adults\u2019 preparations for end-of-life health care","volume":"53","author":"Carr","year":"2012","journal-title":"Journal of Health and Social Behavior"},{"issue":"2","key":"2024070410204384100_CIT0004","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1007\/s10834-022-09839-y","article-title":"Older adults\u2019 relationship trajectories and estate planning","volume":"44","author":"Choi","year":"2023","journal-title":"Journal of Family and Economic Issues"},{"issue":"2","key":"2024070410204384100_CIT0006","first-page":"197","article-title":"Court approval of Medicaid spend-down planning by guardians","volume":"6","author":"Ershow-Levenberg","year":"2005","journal-title":"Marquette Elder\u2019s Advisor"},{"issue":"4","key":"2024070410204384100_CIT0007","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1257\/jep.8.4.145","article-title":"Intergenerational transfers and the accumulation of wealth","volume":"8","author":"Gale","year":"1994","journal-title":"Journal of Economic Perspectives"},{"issue":"1","key":"2024070410204384100_CIT0008","doi-asserted-by":"crossref","first-page":"193","DOI":"10.2307\/3559010","article-title":"Racial differences in patterns of wealth accumulation","volume":"39","author":"Gittleman","year":"2004","journal-title":"The Journal of Human Resources"},{"issue":"2","key":"2024070410204384100_CIT0009","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.jue.2012.05.005","article-title":"Medicaid and the housing and asset decisions of the elderly: Evidence from estate recovery programs","volume":"72","author":"Greenhalgh-Stanley","year":"2012","journal-title":"Journal of Urban Economics"},{"key":"2024070410204384100_CIT0010","first-page":"202","volume-title":"Chapter 9. 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