Making Medicaid Beneficiaries Complete Advance Directives

The Louisiana House of Representatives passed a resolution urging and requesting the state Department of Health and Hospitals to "examine whether or not filling out living wills should be made a mandatory requirement for Medicaid applicants." This seems to violate a widely-accepted rule (in the UHCDA, for example) that the completion of advance directives not be a condition of insurance. Still, so long as the content of the advance directive was left to the beneficiary, it may not be too troubling. And if there actually were a likelihood of problems with this approach, Louisiana could follow Vermont's approach. A Vermont bill proposes to require all health insurance forms and forms for state health programs to contain an advance directive for applicants to complete. It would allow the applicant to check a box to indicate whether he or she wished the advance directive to be legally binding, yet also contain an opt-out provision for applicants who do not wish to complete the form.