The Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized a rule to streamline enrollment in the Medicare Savings Programs (MSPs), making coverage more affordable for an estimated 860,000 people. CMS estimates the improvements will save older adults and people with disabilities nearly 19 million hours in paperwork each year and reduce state administrative burden by over 2 million hours annually.
The MSPs, run by state Medicaid programs, currently cover Medicare premiums and, in most cases, cost-sharing for more than 10 million older adults and people with disabilities who also have limited incomes. The final rule makes it easier for millions of people to enroll in, retain, and afford health coverage and care through Medicare.
“Throughout my career, I have dedicated myself to ensuring that Americans have access to health insurance, so that they can survive and thrive,” said HHS Secretary Xavier Becerra. “This rule brings us closer to that goal as we expand access and coverage for older Americans and people with disabilities.”
Only about half of eligible people are enrolled in the MSPs, in part due to cumbersome application and verification processes now simplified by this rule.
For example, all Medicare-eligible individuals who receive Supplemental Security Income (SSI) are financially eligible for MSPs, but many are not enrolled because of burdensome and duplicative paperwork. Under the new final rule, many SSI recipients will now be enrolled automatically into the most comprehensive form of MSP coverage: the Qualified Medicare Beneficiary eligibility group, which covers Medicare premiums and cost sharing.
Under the rule, states will also make better use of data from the Medicare Part D Low Income Subsidy (LIS) or “Extra Help” program, which helps many older adults and people with disabilities pay for prescription drugs and prescription drug coverage when they live on a limited income. Concurrently, CMS and the Social Security Administration are preparing to implement provisions of the President’s prescription drug law that expands eligibility for the full LIS benefit, allowing an estimated 300,000 people to have lower drug costs starting January 1, 2024.
