State Medicaid Policies Influence Benefits for Low-Income Medicare Recipients

From 2012 to 2016, close to 20 percent of low-income Medicare recipients who were also Medicaid enrollees stopped receiving benefits that paid for services like long-term nursing home care and out-of-pocket deductibles that Medicare doesn’t cover, according to an AHRQ-supported study published in Health Affairs. For some low-income Medicare beneficiaries, Medicaid provides financial protection against Medicare’s out-of-pocket costs, but many Medicare beneficiaries who qualify for Medicaid are not continuously enrolled. The study showed that lapses in Medicaid coverage were lower in states that automatically enrolled Supplemental Security Income program recipients for Medicaid, offered more generous Medicaid provider reimbursements and were less restrictive regarding asset limits to qualify for Medicaid. Researchers concluded that these state policy features, coupled with those that reduce administrative barriers to Medicaid re-enrollment, can support Medicare recipients in maintaining the Medicaid benefits for which they are eligible. Access the abstract.

2019 Jul;38(7):1153-1162. doi: 10.1377/hlthaff.2018.05165.

Association Of State Policies With Medicaid Disenrollment Among Low-Income Medicare Beneficiaries.

Roberts ET1, Hayley Welsh J2, Donohue JM3, Sabik LM4.

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Abstract

For some low-income Medicare beneficiaries, Medicaid provides financial protection against Medicare's out-of-pocket costs, but many Medicare beneficiaries who qualify for Medicaid are not continuously enrolled. We examined Medicaid disenrollment among fee-for-service Medicare beneficiaries and the relationship between disenrollment and state policies. In the period 2012-16, 18.2 percent of Medicare beneficiaries who received full or partial Medicaid disenrolled for reasons other than death. More than 50 percent of Medicare beneficiaries who remained without Medicaid one year after disenrolling continued to receive low-income subsidies for Medicare Part D coverage with eligibility requirements similar to those of Medicaid. Among Medicare beneficiaries with continuous Part D subsidies, the rate of Medicaid disenrollment was 24 percent lower in states that automatically enrolled recipients of the federal Supplemental Security Income program in full Medicaid, 33 percent lower in states with more generous provider payment policies, and 37 percent lower in states with less restrictive asset limits for partial Medicaid. Policies that make it easier for people to maintain Medicaid eligibility and that enhance access to care in Medicaid via higher provider reimbursements may reduce disenrollment.