Does the Affordable Care Act permit the government to seize assets after Medicaid patients age 55 or older die? According to the Florida Times-Union, states have had the option to do that since the Medicaid program started in 1965. In 1993, it became mandatory, and the ACA doesn’t change that. The Times-Union notes the federal health law allows for states to expand their Medicaid rolls to cover more people, so more could be subjected to the Medicaid Estate Recovery Program.