Medicaid is the main reason these laws stopped mattering. Federal law bars state Medicaid programs from counting anyone else's finances when deciding whether an adult qualifies: eligibility rules must "not take into account the financial responsibility of any individual" for an applicant unless that person is the applicant's spouse, or the parent of a minor or disabled child.[9] Your income can't disqualify your mother, and when Medicaid recovers costs, it recovers from her estate, not from you.[9][10]
Once Medicaid existed, indigent parents had a payer, and states started deleting the old support laws. Maryland's 2017 repeal act says this directly: states began repealing filial support laws after the passage of Social Security, Medicare, and Medicaid.[4]
Medicaid does get paid back, from one place. Federal law requires states to recover the cost of nursing facility care and related services from the estate of a Medicaid enrollee who was 55 or older, after death. Recovery waits while a spouse, a child under 21, or a blind or disabled child survives, and every state must have a hardship waiver process.[10] The claim runs against the parent's estate. The children's own money is never the target.
The unpaid months are where trouble happens: care delivered before Medicaid approval, or after a denial. The bill accrues in the parent's name, the facility wants a payer, and Pittas shows a Pennsylvania facility doesn't have to wait for the Medicaid decision before suing a child.[2]
Federal law does draw one hard line: a facility that takes Medicare or Medicaid can't require a third party's guarantee of payment as a condition of admission or continued stay.[11] The CFPB found some facilities pursue family members anyway.[8]