January 21, 2019

Baker plan expands Medicare assistance to seniors

Twenty-five thousand low-income seniors in Massachusetts would be newly eligible for help paying for health care, and thousands more could be eligible for more assistance than they're currently receving, under a measure Gov. Charlie Baker plans to include in his 2020 budget proposal.

Baker's budget, which the governor plans to file on Wednesday, will include language expanding eligibility for Medicare Savings Programs, which help eligible seniors pay for Medicare premiums and out-of-pocket expenses.

"This will make a big difference for people whose out-of-pocket on their drug costs is high," Baker said.

In Medicare Savings Programs, states and the federal government together pay for premium and cost-sharing assistance for Medicare Parts A and B. Participants automatically qualify for federal subsidies for Part D drug coverage.

States establish their own eligibility levels for the program -- in Massachusetts, the limit for the different tiers currently runs from 100 percent to 135 percent of the federal poverty level, or about $12,140 to $16,400 -- and a change would not require federal approval, Baker said.

Baker's plan would increase the income limits to 130 percent to 165 percent of the federal poverty level (about $15,790 to $20,000) and double the asset limit for all three tiers from the current $7,560 to $15,120.

About 18,000 people in Massachusetts are served by the program now and could receive greater benefit levels under the expansion. Another 25,000 who were not previously eligible would be able to participate.

Under the proposed expansion, the out-of-pocket costs for a 79-year-old Bay Stater with $17,000 in annual Social Security income would fall from about $6,000 to $600.

The expansion would be paid for through an additional $100 million in federal Medicare spending, and a $10 million increase in state spending, Baker said.

At least 13 other states have expanded their Medicare Savings Program eligibility beyond the federal minimum, according to the Baker administration. The governor's plan, which needs buy-in from state lawmakers, would be the first time Massachusetts has adjusted eligibility beyond the federal standards since the MSP program began in 1966.

Baker's spending plan next week will serve as the first volley in the months of annual budget debate and development on Beacon Hill. The House will debate its own budget in April and the Senate in May, with the goal of getting a compromise version to Baker's desk before the new fiscal year begins on July 1.

Legislative budget writers can opt to include Baker's recommendations, or to leave them out of their bills.

Baker said he hadn't talked about the expansion with lawmakers. One former House Democrat, Boston Mayor Martin Walsh, is on board.

Walsh, in a statement, said expanding eligibility would be "a significant way to ensure that our seniors have access to high-quality and affordable healthcare coverage."

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