The Medicare Rights Center’s New York Policy experts have released a new paper focused on helping people gain access to Medicare Savings Programs (MSPs). The paper, supported by the West Health Policy Center, includes case studies and policy recommendations derived from the essential work our national helpline does to help people understand and enroll in Medicare benefits and assistance programs like MSPs.
MSPs are Lifelines for People with Low Incomes
MSPs were established in the Medicare Catastrophic Coverage Act of 1988 and subsequently expanded by the Omnibus Budget Reform Act (OBRA) of 1990, the Balanced Budget Act of 1997 (BBA), the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008, and the Medicaid Access and CHIP Reauthorization Act in 2015.
The programs support Medicare enrollees by paying Medicare premiums and other Medicare costs for people with low incomes; automatically enrolling people into the federal Part D Low-Income Subsidy, also known as “Extra Help,” which helps pay prescription drug costs; and helping individuals enroll in Medicare through a process called “buy-in.” These benefits help people afford their care and reduce states’ uncompensated care costs.
MSPs help people afford their care and reduce states’ uncompensated care costs.
Barriers to MSP Enrollment
Standard MSP eligibility rules leave many people without access to the help they need. The income and asset thresholds are extremely low in most states, leaving many struggling people just outside of the eligibility range.
Even those who qualify face barriers. Millions of people within the strict income and asset thresholds are still not enrolled. This may be due to a lack of information about the programs and how to sign up, or people may have difficulty navigating an enrollment process that is notoriously complex. Taken together, an estimated 40% of those who are eligible are missing out on important MSP benefits.
An estimated 40% of those who are eligible are missing out on important MSP benefits.
Unfortunately, Congress has curtailed some federal efforts to increase access to MSPs. The recently passed reconciliation bill halted rules designed to streamline application processes. The Congressional Budget Office projects nearly 1.4 million low-income people with Medicare—more than 10% of the dually enrolled Medicare-Medicaid population—will lose their MSP coverage due to the rollback of these simplifications.
Opportunities Remain
Though the reconciliation bill halted the streamlining rules and made it harder for people to enroll, it did not prevent states from acting.
We urge all states to do more to increase MSP availability, including by raising income thresholds for eligibility and eliminating asset barriers that can make application processes overly burdensome. And some states are taking action: Medicare Rights has successfully advocated for streamlining MSP enrollment and expanding MSP eligibility in New York and other states.
We also encourage all states to make it easier for people to learn about and sign up for MSPs through increased outreach, streamlined applications, and automatic enrollment where income data are already available.
Our New Paper Illustrates Obstacles and Potential Solutions
The case studies in the new paper illustrate the obstacles beneficiaries commonly face when trying to enroll and stay enrolled in MSPs. They also highlight the vital role Medicare and MSPs play in real people’s lives. The policy recommendations come directly from our experience helping people who are struggling to access these essential benefits. Common-sense changes can make significant improvements to people’s ability to manage their health and finances.
The policy recommendations come directly from our experience helping people who are struggling to access these essential benefits.
At Medicare Rights, we remain committed to informing people about Medicare and assistance programs, helping them enroll into these programs, and tackling systemic inefficiencies that burden enrollees. Too many people struggle to pay for their health care and prescription drugs. We urge policymakers to prioritize the health, wellbeing, and financial security of the millions who rely on Medicare and MSPs and to embrace policies that tear down barriers to care.
Read the paper, Medicare Savings Programs: A Lifeline for Millions.
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