Rules put couple in a Catch-22

All but $228 of a spouse's income must go to medical expenses, a state official said.
State food stamp and Medicaid programs have become thorns for Jack Scott of Austintown, who has lost more than $600 in monthly Medicaid benefits since his wife, Dalene, went to work.
Carmen Banks, spokeswoman for the state Department of Job and Family Services, said federal food stamp regulations require physically and mentally fit people between the ages of 15 and 60 to go to work.
Kidney failure: Scott, 72, is considered disabled because he suffers from kidney failure. He lost the function of one kidney after complications from treatment for hardening of the arteries. He discovered the problem when his second kidney failed in 1993 as a complication of open heart surgery.
Although he does not fall within the work criteria, his wife does. Such a spouse is required to work on his behalf, Banks said.
Banks said the regulations are established by the federal government and adopted and enforced by the state agency.
Medicaid rules: But Medicaid regulations, also run by the state, do not require a spouse to work, said Fred Elig, who works within the Medicaid program for the Department of Job and Family Services. Still, besides Scott's income, his wife's income would be considered when determining how much Medicaid benefits Scott receives, Elig said.
The working spouse is allowed $228 of her gross monthly income; the Medicaid program requires the rest to go toward medical expenses before the state will pay the remainder, Elig said.
Until his wife went to work, Scott was required to foot $441 of his monthly medical expenses before Medicaid would pay the rest. Now, he must pay $1,064.
Although a working wife would not receive any of the Medicaid benefits, her medical costs could be applied to the amount the couple must spend before the husband's benefits begin.
It is a common complaint, Elig said, that the guidelines do not allow for living expenses. The department is continually looking to improve the system, he added.