This piece is adapted from a paper written for a legal philosophy course taught by Professor Heidi Li Feldman. The piece examines state-sponsored social security benefits available to retirees in America, focusing on policies like spend-down requirements and the Estate Recovery program. It then argues that such policies incentivize Medicaid planning, a practice that disproportionately shifts the burden of the negative effects of these policies onto lower-income retirees and perpetuates economic inequality across generations. Borrowing from David Hume’s “Of Commerce” and “Of Refinement in the Arts,” the piece considers how policymakers should conceive of “surplus” assets and income among retirees. It frames Medicaid planning as a “luxury” under Hume’s theory, then examines whether it is an “innocent luxury” or a “vicious luxury” that policymakers should seek to deter. Rather than penalizing those who engage in Medicaid planning, the piece argues that lawmakers should update asset limits and reform estate recovery to decrease the necessity of Medicaid planning.

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