What Are Filial Responsibility Laws?

Laws at both the federal and state levels require adult children to be financially responsible for paying for long-term care facilities and to seek reimbursement for unpaid bills. You may someday be on the hook for thousands of dollars' worth of care required by aging parents — but that's not the whole story.
More than half of all states and Puerto Rico hold adult children financially accountable in some way for expenses such as a parent's medical care and basic needs when that parent is impoverished. New Hampshire, on the other hand, has taken steps to limit children's responsibilities. Arkansas requires adult children to pay only for mental health care. Some states place time limitations on how long adult children are required to pay.

Most states take an adult child's ability to pay into account. People who do not have sufficient income to pay are not held liable for these debts. But seniors in such cases can face problems. Sometimes patients are isolated, and their families have no access to information about how to apply for Medicaid. The pandemic made such isolation common. In these cases, family members have no adequate resources to pay for long-term care, and the debt just continues to grow.

States and Demographic Trends
The combination of aging baby boomers and increased longevity means that states attempting to balance their budgets are dusting off their largely ignored filial responsibility laws and resurrecting them. They are holding adult children legally responsible for the support of their financially strapped parents, including for costs like food, medical treatments and long-term care.

Some states are seeking to reduce Medicaid costs, and that may mean that filial responsibility laws may raise their heads. Children may have to provide services not provided by Medicaid. Pennsylvania, seeking to reduce its Medicaid outlays, decided in 2005 to update provisions requiring immediate family members to contribute to cost of care. Under that law, an adult son was found liable for his mother's $93,000 nursing home bill following an automobile accident. The court declared him responsible even though a Medicaid application was in progress.

Similar suits have cropped up throughout the country. Laws vary greatly, with 21 states allowing cost recovery through civil suits. Wages can be garnished, liens imposed on property and credit reports tarnished. A dozen states impose criminal penalties.

Medicaid estate recovery laws allow nursing homes and long-term care providers to seek reimbursement for long-term care costs from the estate of a deceased person. If your parents transferred assets to a trust, then your state's Medicaid program may be able to recover funds from the trust. Medicaid recovery efforts could shrink the pool of assets you stand to inherit.

State laws vary, but most agree that children have a duty to provide necessities for parents who cannot do so for themselves. States' legislation gives guidelines to the courts. Judges have considered such variables as the adult child's financing of a child's college education and his or her personal needs for savings and retirement.
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You can easily get on the hook for unreimbursed medical expenses that are considered your filial responsibility. However, there are two things you should keep in mind. First, state laws change frequently, so make sure you know where your state stands on filial laws at present. Second, check with an estate attorney for current legal advice.