OHIO LEGISLATIVE SERVICE COMMISSION
Office of Research Legislative Budget
www.lsc.ohio.gov and Drafting Office
S.B. 296 Bill Analysis
135th General Assembly
Click here for S.B. 296’s Fiscal Note
Version: As Introduced
Primary Sponsor: Sen. Brenner
Effective date:
Emma Carroll, Research Analyst
SUMMARY
▪ Exempts funds in an ABLE account from collection under the Ohio Medicaid Estate
Recovery Program to the extent permitted under federal law.
DETAILED ANALYSIS
Overview
The federal Achieving a Better Life Experience (ABLE) Act allows eligible individuals with
disabilities to invest money in tax-advantaged accounts that can be spent on qualified expenses,
including housing, transportation, education, assistive technology, health and wellness expenses,
and others. To be eligible for an ABLE account under the act (also referred to as a STABLE Account
in Ohio), an individual must have developed a qualifying disability before age 26 (the age limit
increases to 46 on January 1, 2026).1
ABLE accounts and Medicaid estate recovery
The bill exempts ABLE accounts from Ohio’s Medicaid Estate Recovery Program. State
Medicaid programs are required by federal law to implement an estate recovery program under
which the state must seek to recoup funds spent on Medicaid services from the estates of certain
deceased Medicaid recipients.2 When such a recipient dies, the Ohio Department of Medicaid
(ODM) certifies the amount due, and the Ohio Attorney General is tasked with collecting the debt
from the recipient’s estate, including homes, bank and investment accounts, and other assets.3
1 R.C.113.53; 26 United States Code (U.S.C.) 529A, not in the bill.
2 42 U.S.C. 1396p(b), not in the bill.
3 R.C. 5162.21; R.C. 5162.212, not in the bill.
November 8, 2024
Office of Research and Drafting LSC Legislative Budget Office
Under state Medicaid recovery programs, the federal law requires recovery of the
following amounts:
1. Expenses for nursing facility services, home and community-based services, and related
hospital and prescription services paid on behalf of a Medicaid recipient over age 55; and
2. All medical assistance paid on behalf of a Medicaid recipient receiving long-term services
and supports in a facility permanently (referred to as “permanently institutionalized”
individuals).
States may elect to apply estate recovery under additional circumstances, for example, by
recovering all medical assistance paid on behalf of a Medicaid recipient over age 55, not just for
nursing facility and associated expenses as under (1) above.4 ODM has elected to exercise that
option.
The bill exempts money in an ABLE account from Medicaid estate recovery to the extent
permitted under federal law.5 Because federal law requires states to exercise Medicaid estate
recovery for the amounts described in (1) and (2) above, despite the bill’s prohibition, it appears
that ABLE accounts may be recoverable by ODM against those individuals for those amounts. The
bill’s prohibition does apply to other individuals subject to Medicaid estate recovery pursuant to
state options.
HISTORY
Action Date
Introduced 06-24-24
ANSB0296IN-135/ts
4 42 U.S.C. 1396p(b).
5 R.C. 113.53(G)(2).
P a g e |2 S.B. 296
As Introduced


Statutes affected:
As Introduced: 113.53