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Federal Action Needed to Enroll More Low-Income Seniors and Disabled Persons in Program to Pay Their Medicare Premiums

NASI Expert Panel Finds Barriers to Enrollment

Embargoed Until: 12:00 noon, EDT, June 12, 2006
Contact: Jill Braunstein at (202) 452-8097 or by e-mail at jillbraun@nasi.org

WASHINGTON, DC—Federal action is needed to enroll more low-income elderly and disabled people in the Medicare Savings Programs, which can help pay their Medicare premiums and other charges, according to a report released today by an independent expert panel of the National Academy of Social Insurance (NASI). The roles and responsibilities of federal and state governments need to be sorted out, the panel said, and additional federal financing should be provided.

“Increasing enrollment in the Medicare Savings Programs is vital in reducing financial barriers to health care for low-income Medicare beneficiaries,” said Jack Ebeler, chair of the study panel and president of the Alliance of Community Health Plans. “Better aligning the Medicare Savings Programs with Medicare's low-income prescription drug subsidy offers an opportunity to increase enrollment in both programs.”

Fewer than one in three eligible low-income persons is receiving benefits from the Medicare Savings Programs, which help pay Medicare's premiums and cost sharing for hospital and physician services. A separate subsidy helps with the premiums and cost sharing for Medicare's prescription drug benefit.

The study panel identified the following as the top barriers to enrollment:
  • Lack of awareness that the programs exist,
  • An eligible population that is hard to reach due to age, impairments, or language barriers,
  • A burdensome application process,
  • Reluctance to apply for benefits through a state Medicaid agency, and
  • Misunderstanding the programs' limits on assets.
The study panel offers several options for increasing enrollment in the Medicare Savings Programs. The options build on the Social Security Administration's ongoing efforts to enroll people in Medicare's low-income prescription drug subsidy. One approach would use the information gathered by Social Security to make the current Medicare Savings Programs work better, without changing current eligibility rules or administrative responsibilities. A more expansive, and expensive, course of action would simplify and liberalize the eligibility rules to provide greater uniformity between the Medicare Savings Programs and the low-income drug subsidy. Still another alternative is to adopt more limited changes that would facilitate a gradual increase in the federal financial and administrative role.

The panel's conclusions are described in detail in its final report, Improving the Medicare Savings Programs, which is available for download free-of-charge.

The National Academy of Social Insurance is a nonprofit, nonpartisan organization made up of the nation's leading experts on social insurance. Its mission is to promote understanding and informed policymaking on social insurance and related programs through research, public education, training, and the open exchange of ideas. The Commonwealth Fund, a New York City-based private, independent foundation, provided the primary financial support for this project. Dissemination of the report is made possible by support from the W.K. Kellogg Foundation.


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