[Congressional Record Volume 148, Number 105 (Monday, July 29, 2002)]
[Extensions of Remarks]
[Page E1449]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        MEDICARE BENEFICIARY ASSISTANCE IMPROVEMENT ACT OF 2002

                                 ______
                                 

                          HON. JOHN D. DINGELL

                              of michigan

                    in the house of representatives

                         Friday, July 26, 2002

  Mr. DINGELL. Mr. Speaker, today my colleagues and I are introducing a 
bill that will make significant and long-overdue improvements in the 
programs that provide assistance to low-income Medicare beneficiaries. 
Medicare provides coverage to all 40 million elderly and disabled 
beneficiaries, regardless of income, but the cost of uncovered 
services, premiums, and cost-sharing is a serious burden on those with 
the lowest incomes.
  More than 40 percent of Medicare beneficiaries have incomes below 200 
percent of poverty (a little more than $17,000 a year). These low-
income beneficiaries are nearly twice as likely as higher-income 
beneficiaries to report their health status as fair or poor, but are 
less likely to have private supplemental insurance to cover the cost of 
uncovered services or Medicare cost-sharing. Poor beneficiaries also 
bear a disproportionate burden in out-of-pocket health care costs, 
spending more than a third of their incomes on health care compared to 
only 10 percent for higher-income beneficiaries.
  Medicaid, through what is known as the ``Medicare Savings Programs,'' 
fills in Medicare's gaps for low-income beneficiaries, providing 
supplemental coverage to 17 percent of all Medicare beneficiaries. 
Millions of beneficiaries, however, who are eligible for assistance 
under the Medicare Savings Programs are not enrolled. For example, only 
half of the beneficiaries below poverty who are eligible for assistance 
are actually enrolled. Lack of outreach, complex and burdensome 
enrollment procedures, and restrictive asset requirements keep millions 
of seniors from receiving the assistance they desperately need.
  The Medicare Beneficiary Improvement Act of 2002 takes a number of 
steps to address these problems. First, the legislation improves 
eligibility requirements for these programs. It raises the income level 
for eligibility for Medicare Part B premium assistance from 120 percent 
to 135 percent of poverty. This expansion was originally enacted in 
1997 but it expires this year; it is simple common sense to make this 
provision permanent. The bill also ensures that all seniors who meet 
supplemental security income (SSI) criteria are automatically eligible 
for assistance. Currently, automatic eligibility is only required in 
certain states, meaning that beneficiaries in other states may miss out 
on critical assistance unless they know enough to apply. The bill also 
eliminates the restrictive asset test that requires seniors to become 
completely destitute in order to qualify for assistance. Most low-
income Medicare beneficiaries have limited assets to begin with--85 
percent of beneficiaries with incomes below the poverty level have 
fewer than $12,000 in assets--but the asset restrictions are so severe, 
a beneficiary could not keep a fund of more than $1,500 for burial 
expenses without being disqualified from assistance.
  Second, the legislation eliminates barriers to enrollment. The 
legislation allows Medicare beneficiaries to apply for assistance at 
local social security offices, encourages states to station eligibility 
workers at these offices (as well as at other sites frequented by 
senior citizens and individuals with disabilities), and ensures that 
beneficiaries can apply for the program using a simplified application 
form. In addition, this bill will ensure that once an individual is 
found eligible for assistance, the individual remains continuously 
eligible and does not need to re-apply annually.
  Third, the legislation improves assistance with beneficiary out-of-
pocket costs. It provides three months of retroactive eligibility for 
``qualified Medicare beneficiaries'' (QMBs). All other groups of 
beneficiaries have this protection currently. In addition, it prohibits 
estate recovery for QMBs for the cost of their cost-sharing or benefits 
provided through this program. The fear that Medicaid will recoup such 
costs from a surviving spouse is often a deterrent for many seniors to 
apply for such assistance.
  Finally, the legislation funds a demonstration project to improve 
information and coordination between federal, state, and local entities 
to increase enrollment of eligible Medicare beneficiaries. This 
demonstration would help agencies identify individuals who are 
potentially eligible for assistance by coordinating various data and 
sharing it with states for the purposes of locating and enrolling these 
individuals. In addition, the legislation provides grant money for 
additional innovative outreach and enrollment projects for the Medicare 
Savings Programs.
  All told, this legislation should go a long way in making sure that 
the Medicare Savings Programs are working as they should to provide 
assistance with health care cost-sharing and premiums for vulnerable 
low-income seniors. As Congress addresses Medicare issues this year, we 
must ensure that in addition to addressing provider payments, we also 
address these important beneficiary protection issues as well. I look 
forward to working with my colleagues to pass this legislation.

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