Q: What should I do if mom refuses to sign papers to have her life insurance assets spent down in order to qualify for Medicaid?

A: It might be better to try and convince your mom to sell you the policy. Then she can feel that she's kept the policy in force, but it would no longer be a Medicaid asset once it's transferred to you (you would then become the owner, your mom the insured).

In exchange, you give her cash, which can then be spent down (or, preferably, converted to a non-countable asset like a car or pre-paid funeral/burial, etc.). If you don't have the cash to pay her, you could borrow against your mom's cash value in the policy.