Published in RINewsToday on March 25, 2024
A few weeks ago, advocates for seniors gathered on Smith Hill, attending a Senate Committee on Health & Human Services hearing to push for passage of S. 2399. The legislation would expand income eligibility for the Medicare Savings Program (MSP), helping many lower income seniors and disabled residents pay their $175/month Medicare Part B premium and covering co-pays and deductibles for those with very low-income.
Thousands of low-income seniors and persons with disabilities on Medicare, but not eligible to participate in the state’s Medicaid program, struggle to pay their Medicare Part B premiums and co-pay costs for services and prescription drugs causing many to forgo needed health care as they cannot afford to pay the co-payments.
S. 2399, introduced by Pawtucket Sen. Sandra Cano (D-Dist. 8, Pawtucket), would expand eligibility for the Medicare Savings Program (MSP) by increasing the income limit to 186% of the federal poverty line and eliminating the strict asset limit. It also increases from 100% to 138% of the federal poverty line a part of the program that covers deductibles and co-payment.
S. 2399 was heard on March 12, 2024 and held for further study. At press time, H. 7333, introduced by Pawtucket Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls), has been referred to the House Finance Committee for consideration. No hearing date has been scheduled.
“With health care costs rising at an alarming rate, it is imperative that we make sure that no one goes without the care they need due to unaffordability. This bill adapts to the significant changes in our society and economy while also ensuring that our most vulnerable senior and disabled residents are able to access the care and medicine that is essential to their daily lives,” said Cano, who champions S. 2399 and in previous legislative sessions introduced legislation to expand the MSP.
“Too many of our low-income seniors and disabled residents are falling through the cracks and foregoing crucial health care services due to rising co-pays and out of pocket costs. This is unacceptable, but thankfully, we can do something about it. By passing this legislation, thousands or more Rhode Islanders will be able to receive the care that they desperately need while also keeping more money in their pockets that’s needed for daily living expenses,” said Alzate, who sponsored the House companion measure.
“We understand this is very important legislation. We had a very informative, thorough hearing on this bill, and I look forward to reviewing all the information we collected.” says Senate Health and Human Services Committee Chairman Joshua Miller (D-Dist. 28, Cranston, Providence).
The Policy Problem and its Solution
Currently, the income limit of $20,331 leaves thousands of older Rhode Islanders and disabled low-income persons on Medicare with significant gaps in coverage and hefty out of pocket costs.
If the MSP income limit is increased to $28,012, as required by the legislation, an estimated 17,000 persons would be newly eligible to have their Medicare Part B covered by being enrolled in MSP. Anyone enrolled in the MSP receives automatic enrollment in Part D “Extra Help,” a federal program which significantly lowers out-of-pocket Medicare prescription costs at no cost to the State. The federal government establishes the minimum income and asset thresholds for the MSP, and states are permitted to increase these limits and many have done so.
Advocates of Cano’s MSP legislative proposal say it also particularly helps Rhode Island’s older woman and minorities. “Since women and people of color and persons with disabilities are disproportionately represented in low-income populations, increasing access to the MSP promotes equity,” finds an advocacy partnership’s analysis of the legislative proposals. “Poverty rates among older adult Hispanic women are two and one-half times that of older Hispanic men and persons age 18 and over with disabilities are twice as likely to live below 150% of the poverty level, said the analysis.
The advocacy partnership’s analysis also noted that significant numbers of older adults and those with disabilities enrolled in Medicare face financial challenges meeting basic needs. The number of older adults living below or near poverty has increased, housing costs have climbed dramatically, food cost have increased and many more rely on food pantries.
Covering the $175/month Medicare Part B premium for 17,000+ Rhode Islanders (at no cost to the State) and additionally covering co-pays and deductibles for thousands of very low-income adults and persons with disabilities on Medicare will give them much needed financial relief. And enrollment in the Extra Help program to reduce drug-related costs provides significant additional financial assistance and improves access to critical medication.
Testimony At the Senate Committee Hearing
Nine organizations either testified at this hearing or submitted written testimony to urge passage of S. 2399. AARP Rhode Island did not testify at the hearing but signed up in support in the committee room. There was no opposition to Cano’s legislative proposal.
“I first became aware of the need to expand the income eligibility for MSP quite a few years ago when an older man in my neighborhood contacted me to tell me he lost out on the program because he was just a few dollars over the income limit. As a result, the Senior Agenda Coalition of RI (SACRI) has advocated for several years to increase the income cap,” says Maureen Maigret, SACRI’s policy Advisor.
It’s a win-win for both older Rhode Islanders and for the Rhode Island General Assembly, says Maigret. “S. 2399 would help Medicare beneficiaries to access care along with putting money back in their pockets to pay for food, rent and their basic needs. By increasing the Medicaid income to $28,012, the federal government will pay the full cost of the newly eligible Medicare beneficiaries,” she told the lawmakers.
Strongly supporting S2399, Karen Malcolm, of Protect Our Healthcare Coalition, noted that the legislative proposal is modeled on the MSP changes enacted in New York last year and approved by the Centers for Medicare and Medicaid Services. “Rhode Island should take advantage of the opportunity to expand access to affordable coverage for seniors and people with disabilities and bring new [federal] revenue to our state.”
H. Phillip West, Jr. lobbyist for the Village Common of Rhode Island, states MSP already makes an enormous difference for many beneficiaries. But, “Rhode Island’s low threshold for eligibility and low allowable assets leaves thousands of our needy neighbors out. The good news is that Senator Cano’s legislation address these defects,” he said.
In submitted written testimony, Heather Smith, MD, president of the Rhode Island Medical Society stated “From our perspective as physicians, we witness firsthand the adverse effects of financial barriers on patient health outcomes. Too often, individuals are forced to forgo or ration medications, delay necessary treatments, or skip preventative care due to concerns of affordability. These delays can exacerbate health conditions, lead to complications, and ultimately result in higher healthcare costs down the road.”
Alex Moore, political director of SEIU 1199NE, stressed the many benefits of passing S. 2399, specifically enhancing access to care, providing needed financial relief, leveraging federal funds, and strengthening the health care workforce. By supporting the legislative proposal, “we demonstrate our commitment to health and well-being of our state’s most vulnerable populations,” he stated in written testimony.
Even with the strong support of the aging community, the state’s Office of Healthy Aging has not yet taken an official position on S. 2399. “As with any other bills at this stage of the session, we are reviewing the impact of H 7333 and S 2399 on Rhode Islanders. We will continue to follow these bills as they make their way through the legislative process,” says Director Maria Cimini.
Samuel Salganik, JD, executive director of RIPIN, which offered testimony in support for S.2399, said, “This is one of the best investments available right now for our state government. At a cost of just over $5 million, the State can draw down more than $40 million in federal support to assist low-income seniors in Rhode Island,” says Salganik. “It’s a great deal for the state. I think that’s a deal that most of us would happily take,” adds Salganik.
Gov. Dan McKee’s recently released FY 2024 Budget does not include funding for to expand the state’s MSP. Now the ball is in House Speaker Joseph Shekarchi’s (D-Dist. 23, Warwick) court as his chamber collaborates with the Senate to hammer out budget resolution to be approved by the Rhode Island General Assembly to be sent for the Governor’s signature. Hopefully, Shekarchi will see the expansion of the state’s MPM as a win-win for lower-income and disabled persons on Medicare and the state. As supporters of S 2399 and H 7333 say, “it’s a no brainer.”
The Advocacy Partners for MSP Expansion was established to push for the passage of S 2399 and H 7333 during this legislative session. They are: the Senior Agenda Coalition of Rhode Island, Rhode Island Organizing Project, RIPIN, the Economic Progress Institute, the Protect Our Healthcare Coalition and the Ocean State Center for Independent Living.
To access the bills under consideration: http://webserver.rilegislature.gov/BillText/BillText24/SenateText24/S2399.pdf – http://webserver.rilegislature.gov/BillText/BillText24/HouseText24/H7333.pdf
Expanding the income eligibility for the Medicare Savings Program (MSP) is one of the legislative priorities of the Senior Agenda Coalition of Rhode Island. These policy issues will be discussed at its upcoming Legislative Leaders Forum scheduled on Wednesday, March 27, 2024, from 10:00 a.m. to 11:00 a.m., at the Crowne Plaza Hotel, 601 Greenwich Ave,, Warwick, RI.
The Senior Agenda Coalition of RI’s Annual Legislative Leaders Forum is this week:
Tag Archives for Village Common of Rhode island
My most popular reads as an “age beat” journalist in 2022
Published in RINewsToday on January 2, 2023
As an ‘age beat’ journalist for over 43 years, I have freelanced more than 867 stories covering aging, health care and medical issues. These authored and coauthored pieces have appeared in national, state, trade and association publications and even statewide news blogs. In 2022, my articles appeared weekly in 52 issues of RINewsToday.com. Here are the top five articles read on this state-wide blog last year.
“Aging in Place in Your Rhode Island Community,” published in the May 2, 2022 issue of RINewsToday.
According to this article, the aging of the nation’s population continues with seniors choosing to live out their remaining years, aging in place in their communities. The article discusses the findings of a study of adults age 50 and older conducted by the AP-NORC Center for Public Research and the SCAN Foundation. This study confirms that a majority of older respondents would like to age in place and are confident they can access needed health care services that will allow them to stay at home for as long as possible.
In this article, Mary Lou Moran, Director, Pawtucket Division of Senior Services at the Leon Mathieu Senior Center, who noted, “the coordination, accessibility, and connection to services and programs is critical to the successful delivery of services and is where much work needs to be done.
Moran stressed the importance of senior centers located in communities throughout the state that delivered needed information and assistance to seniors on accessing the needed services to age in place. Social isolation, access to transportation, food and housing insecurity, economic stability, and connectivity to services, are obstacles to enabling a person to stay in the community in their homes, says Moran.
Maureen Maigret, policy consultant and Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council, also described state programs that assist seniors age in place in Rhode Island.
Finally, the article gave a history of the National Village to Village Movement and its impact on Rhode Island. It noted that The Village Common of Rhode Island (TVC), with programs in Providence, Barrington, Edgewood/Cranston, and Westerly, provides supports to keep seniors at home through the efforts of almost 200 trained and vetted volunteers.
TVC supports include transportation, running errands, home visits and telephone assurance, minor home repairs and light yard work, assistance with technology, and a virtual caregiver support program. A robust weekly calendar offers virtual events, and a monthly newsletter keeps members and guests informed.
To read this article, go to https://rinewstoday.com/aging-in-place-in-your-rhode-island-community-herb-weiss/
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“Calls for Rhode Island to Become more “Age Friendly,” published in the Jan. 24, 2002 2022 issue of RINewsToday.
This article gave a background of a United Nation’s initiative to create “age friendly” communities. Over two years ago, a proposal was endorsed by the 73rd World Health Assembly. It was presented to the U.N. General Assembly Dec. 14, 2020, (Resolution 75/131), leading to the proclamation of a U.N. Decade of Healthy Aging (2021-2030).
The four-page Resolution expressed concern that, despite the predictability of population aging and its accelerating pace, the world is not sufficiently prepared to respond to the rights and needs of older people. It acknowledges that the aging of the population impacts our health systems but also many other aspects of society, including labor and financial markets and the demand for goods and services, such as education, housing, long-term care, social protection and information. It thus requires a total whole-of-society approach to make “age friendly” changes.
Maureen Maigret, policy consultant and chair of the Aging in Community Subcommittee of Rhode Island’s Long-Term Care Coordinating Council, noted that many Rhode Island communities are involved to 1 degree or another in what we consider age-friendly activities. “The initiative is usually led by the local senior center and in some instances volunteer programs such as RSVP and AARP and The Village Common of RI,” she says.
According to Maigret, over the last five years the state’s Long-Term Care Coordinating Council Aging (LTCCC) in Community Subcommittee has adopted and continues to work to support WHO’s decadelong initiative, adding the domains of Food & Nutrition and Economic Security and Supports to Remain at Home.
Newport was the first community to join the AARP age-friendly network; Cranston, Providence and Westerly following. The state’s Office of Healthy Aging has adopted its State Plan on Aging, calling for Rhode Island to become an age-friendly state, says Maigret.
Maigret called on Rhode Island’s cities and towns review their community’s Comprehensive Plans to see how age-friendliness is addressed. “This is what Newport did.
To read this article, go to https://rinewstoday.com/calls-for-rhode-island-to-become-more-age-friendly-herb-weiss/
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“Bill would (Re)create a RI Department of Healthy Aging,” published in the March 21, 2022 issue of RINewsToday.
This article described a legislative proposal on Smith Hill to transform the state’s Office of Healthy Aging (OHA) into a department making it far more visible and effective as an advocate for the state’s growing senior population. H. 7616, introduced by Rep. Lauren H. Carson (D-District 75, Newport), would expand the office in the Department of Human Services (DHS) into a full-fledged state department, expand its director’s authority, and appoint local senior centers as hubs for service delivery, with authority to bill Medicaid for transportation services.
The RI Department of Elderly Affairs (DEA) was created by law in 1977 and remained a department until 2011, when the legislature changed it to a division within the Department of Human Services (DHS). In 2019, the department was re-named the Office of Healthy Aging (OHA), shifting narratives and perceptions associated with growing older. At press time, the Office of Healthy Aging remains a division under the Department of Human Services.
“Restoring the OHA to a department status will strengthen its position at the budget table and elevate the importance of programs supporting older residents of our state. We hope that will make a difference,” says Bernard J. Beaudreau, Executive Director of the Senior Agenda Coalition of Rhode Island.
.“The legislation proposed by Rep. Carson elevates the conversation about the importance of age-friendly policies that enable Rhode Islanders to choose how we live as we age,” said AARP Rhode Island State Director Catherine Taylor. “AARP Rhode Island looks forward to being part of this conversation and continuing to advocate fiercely at both the state and local levels for enhanced home and community-based supportive services, accessible and affordable housing and transportation options, and full inclusion of people of all ages and abilities in community life,” she said.
According to Maureen Maigret, policy consultant and chair of the Aging in Community Sub-committee of Rhode Island’s Long-Term Care Coordinating Council, H 7616 is a very significant bill that will help to stimulate a long due discussion as to how the state should fund senior programs and services in light of the state’s growing age 65 and older population. This age group is projected to represent at least one in five of the state’s residents by 2040.
To read this article, go to
https://rinewstoday.com/bill-would-recreate-a-ri-department-of-healthy-aging-herb-weiss/
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“RI Candidates for Governor Spotlight Senior Issues at Forum,” published in the August 8, 2022 issue of RINewsToday.
This article reported on a 143-minute Rhode Island Gubernatorial form where five Democratic and one Republican gave two minute responses to seven questions previously given to them by the Senior Agenda Coalitionof Rhode Island (SACRI). These questions were intended to how these candidates if elected Governor would fix Rhode Island’s fragmented long-term care continuum and provider payment systems.
According to Bernard J. Beaudreau, Executive Director of the Providence-based SACRI about 300 seniors and aging advocates came to personally see the Gubernatorial candidates outline their position on aging issues. Multiple platforms on Facebook and YouTube were promoted by a variety of senior advocacy groups that resulted in the over 300 virtual audience. Some held “watch parties” at one or more of the 12 senior centers, with approximately 135 people participating from throughout the state.
Maureen Maigret, chair of the Long-Term Care Coordinating Council’s Aging in Community Subcommittee and SACRI Board Member reported that all candidates supported: “making the Office of Healthy Aging a full cabinet/department with review of sufficiency of resources; expansion of Medicare Savings Program which I have been advocating for at least 5 years and adding a state COLA to SSI payments; requiring better data on minority older adult inclusion; addressing community living, housing and transportation needs of older persons and developing and implementing a comprehensive, interdepartmental strategic Plan on Aging.
To read this article, go to
https://rinewstoday.com/ri-candidates-for-governor-spotlight-senior-issues-at-forum-herb-weiss/
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“Larson Pushes to Get Social Security Reform Proposal for House Vote, published in the June 13, issue of RINewsToday.
This article reported that the House Ways and Means Committee was preparing for a full mark-up on H.R. 5723, Social Security 2100: A Sacred Trust, authored by Committee Chairman John B. Larson (D-CT) this summer.
Larson says that over 200 House Democrats [no Republican has yet to support the proposal], are cosponsoring H.R. 5723. Forty-two national organizations (aging, union, veterans, disability, and consumer health organizations) are calling for passage of H.R. 5723, including the Leadership Council on Aging Organizations and the Strengthen Social Security Coalition representing hundreds of national and state aging organizations.
According to a legislative fact sheet, H.R. 5723 both expands the program’s benefits and financially strengthens its. Here are a few provisions:
Specifically, it would give a benefit bump for current and new Social Security beneficiaries by providing an increase for all beneficiaries (receiving retirement, disability, or dependent benefits).
The proposal would also protect Social Security beneficiaries against inflation by adopting a Consumer Price Index for the Elderly (CPI-E), to better reflect the costs incurred by seniors who spend a greater portion of their income on health care and other necessities.
This legislative proposal protects low-income workers by providing a new minimum benefit set at 25% above the poverty line and would be tied to wage levels to ensure that minimum benefits does not fall behind.
It is expected that Larson will reintroduce this legislative proposal next Congress. To read this article, go to https://herbweiss.blog/2022/06/13/larson-pushes-to-get-social-security-reform-proposal-for-house-vote/
Herb Weiss 