Actually the State is just trying to get reimbursed for the money it spent on your health care while you were alive... why do people think there is a free lunch?
The state is covering your medical cost... once you are dead, they are trying to get reimbursed what they can for it. I doubt very highly they are made whole the overwhelming majority of the time since you have to be poor to qualify for Medicaid in the first place.
Do people have a choice?
If its ‘insurance’ then why is the reimbursement necessary?