...placed on their homes if not insured? Scenerio:

Two spouses, neither with LTD insurance. One spouse requires continued long term care at a facility. If Medi-Cal picks up the cost beyond what the care recipient can pay, will the state place a lien on the home or require it to be sold to pay the bill?
Two spouses in California, neither with LTD insurance. One spouse requires continued long term care at a facility. If Medi-Cal (CA's Medicaid) picks up the cost beyond what the care recipient can pay, will the state place a lien on the home or require it to be sold to pay the bill? Does this vary from State to State?

Yep! And if they transfer the deed within 5 years of the need for care, the state can still attach the lien on the property or deny coverage. Many an elderly parent has transferred the deed to their property to their children in an attempt to hide the assets and were shocked to learn that the state could and would take the property anyway.