Gov. Baker’s Budget Plan Would Expand Medicare In Massachusetts

The plan calls for expanding the state's Medicare Savings Program — which pays a portion of premiums and deductibles — to include individuals who are 65 years and older, and whose income doesn't exceed 200% of the federal poverty level. The state's current limit is 165% of the federal poverty level.

Baker administration officials said the plan will cost about $21 million and reduce out-of-pocket health care spending and prescription drug costs for an estimated 34,000 low-income seniors and disabled residents. Another 15,000 seniors currently enrolled in the program will get more help with their health care expenses.

Under the changes, which are subject to legislative approval, a 79-year-old Medicare recipient with $22,000 in social security income could see a drop in out-of-pocket health care costs from an estimated $4,300 to $450 a year, according to data provided by the Baker administration.

Senior advocates, who have pushed for the changes for years, welcomed Baker's push to expand the program and said it will help tens of thousands of elderly residents to afford rising health care and prescription drug costs.

"We have one of the highest gaps between what it costs to live and meet basic needs and the income that people have as seniors," said Mike Festa, state director of the Massachusetts chapter of the American Association of Retired Persons. "The economic security for seniors in our state is wide and significant."

Festa said the plan to expand the program acknowledges the financial stress on many seniors and will "bring real relief to those who are most in need."

By expanding eligibility for the program, the Baker administration says the state will enable more low-income older adults to automatically qualify for $200 million in Medicare Part D subsidies.

Those subsidies will further reduce prescription drug costs for low-income older adults, according to the administration.

Carolyn Villers, executive director of the Massachusetts Senior Action Council, also praised Baker's push to expand the program but is calling on legislative leaders to go even further by increasing eligibility to 225% of the federal poverty limit and eliminate the state's asset limits to qualify for the program.

"Rising costs due to the pandemic and sharp increases in Medicare expenses has made it harder for many seniors living on fixed incomes to keep their heads above water," she said.

"So we're urging the Legislature to build on what the governor has proposed."

Baker expanded eligibility for the Medicare program in the previous budget, increasing the limit from 135% to 165% of the federal poverty level.

His latest pitch to expand the program comes as many elderly Medicare recipients are digging deeper into their pockets to pay their premiums this year.

The U.S. Centers for Medicare & Medicaid Services says the standard monthly premium for Medicare Part B enrollees, which covers outpatient care and other services, will be $170.10 this year, an increase of 14.5% from 2021.

The annual deductible for all Medicare Part B beneficiaries will be $233 in 2022, an increase of $30 from last year, according to the federal agency.

Meanwhile, for Medicare Part A, which covers inpatient hospital, hospice and inpatient rehabilitation, the 2022 deductible will be $1,556, up 4.85% from last year.

An estimated 1.3 million Massachusetts residents get health insurance through the Medicare programs, according to federal data.

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group's newspapers and websites. Email him at [email protected].