Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

Medicare Affordability and Enrollment Act: Important Protection Introduced for Beneficiaries

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Senate Finance Committee Ranking Member Ron Wyden, D-Ore, introduced the Medicare Affordability and Enrollment Act on Wednesday, September 21, 2016. The Bill would improve low-income protections for beneficiaries, eliminate the two-year waiting period for people with disabilities to enroll in Medicare, and reduce late enrollment penalties. The Center for Medicare Advocacy strongly endorses the Bill.

It is important to keep in mind when considering changes to Medicare that half of all Medicare beneficiaries have annual incomes under $24,000, with limited savings, and high out-of-pocket costs. Importantly, the legislation would lower out-of-pocket costs for Medicare beneficiaries by creating a cap on spending, expanding the number of people eligible for Medicare Savings Programs (low-income assistance programs), and updating enrollment to better serve beneficiaries.

The legislation would also eliminate the current two-year waiting period for Medicare coverage for individuals with disabilities. The waiting period harms individuals with disabilities by delaying their access to Medicare and needed care. The Center also strongly supports the Bill’s provision limiting the lifelong Part B late enrollment penalty. The Center also supports extending funding for outreach and education activities like the SHIPs, which serve a key role in assisting beneficiaries.

The Bill’s Senate co-sponsors include Debbie Stabenow, D-Mich., and Michael Bennet, D-Colo., Bill Nelson, D-Fla., Sherrod Brown, D-Ohio.

House Energy and Commerce Committee Ranking Member Frank Pallone, Jr., D-N.J., and House Ways and Means Committee Sander Levin, D-Mich., are leading the introduction of a counterpart in the House of Representatives.

Highlights from the Medicare Affordability and Enrollment Act

  • Caps the total amount of out-of-pocket cost sharing for Parts A and B at $5,500 for 2018
  • Limits the Part B late enrollment penalty for Part B enrollment to ten percent per month for twice as long as an eligible individual delayed obtaining Part B
  • Increases the income level for Qualified Medicare Beneficiaries (QMBs) from 100 to 135 percent of FPL for 2018
  • Increases the income level for Specified Low-Income Medicare Beneficiaries (SLMBs) from 120 to 150 percent of the Federal Poverty Level (FPL) for 2018
  • Aligns Medicare Low Income Subsidy (LIS) and MSP eligibility and resource tests by increasing the QMB, SLMB, and Qualified Disabled Working Individual (QDWI) resource standards
  • Eliminates the two-year period that individuals with disabilities must wait under current law before their Medicare coverage begins
  • Reduces by half the amount of any coinsurance or copayments applicable to items and services furnished under Medicare Parts A and B for low-income beneficiaries
  • Aligns the open enrollment and general enrollment periods Beginning in 2017

Conclusion

The Medicare Affordability and Enrollment Act would provide important protections for the older people and people with disabilities who rely on Medicare to access necessary care.  The Center for Medicare Advocacy thanks those who wrote and introduced this Bill, which we strongly endorse.

Additional Information

September 22, 2016 – K. Kertesz

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