- Associated Press - Tuesday, September 1, 2015

COLUMBUS, Ohio (AP) - Ohio is illegally excluding spouses from the definition of family when determining eligibility for state assistance, a federal appeals court said in a Tuesday ruling that advocates estimate could affect up to 100,000 people.

The decision by the 6th U.S. Circuit Court of Appeals in Cincinnati involves calculations the state makes when determining whether certain seniors on Medicare are eligible for such assistance. The calculations are based on federal poverty levels, which vary depending on family size.

The Ohio Department of Medicaid treated individuals applying for the assistance as a family of one, according to the appeals court ruling. But the state doesn’t have that leeway when it comes to such a basic definition, said Judge Raymond Kethledge, writing for a three-judge majority.

Asking whether “spouse” should be included in the definition of a family “is like asking whether our solar system includes the planet Venus,” Kethledge wrote in the decision overturning a lower-court judge’s ruling.

Messages were left for the state Department of Medicaid.

Miriam Hirsch Sheline, an attorney with the Cincinnati-based Pro Seniors advocacy group, said the Tuesday ruling affects between 80,000 and 100,000 individuals. She said it also has far-reaching implications because 16 states follow a similar rule as Ohio.

Federal law requires states that receive Medicaid money - used for poor children and families - to help certain poor people on Medicare with extra Medicare expenses, such as copayments and deductibles.

The 2012 lawsuit was brought by three Ohioans on Medicare, each with a monthly income of about $1,300, according to the appeals court decision. The plaintiffs argued that amount would make each eligible for Medicaid assistance for out-of-pocket Medicare payments if their spouses were included in the family definition.

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