Cutting Medicaid eligibility hurts Medicare, too

Florida lawmakers cut $98 million from the Medicaid program for “non-pregnant” adults who need retroactive Medicaid. This translates to a cut primarily targeting seniors and persons with disabilities.

Medicaid cuts in general put the most vulnerable Floridians at risk of losing much-needed coverage.

This cut exposes previously uninsured people with significant illness and disability to enormous debt. Our state already ranks near the bottom of the list — 46th in the nation — for its rate of insured residents.

But another lesser-known group hurt by this cut will be low-income Medicare beneficiaries, also known as “dual eligibles” since they receive both Medicare and Medicaid benefits. For them, it means losing out on a $402 benefit to help cover out-of-pocket costs. These dollars will continue flowing in every other state.

Medicare is the federal health insurance program for people 65 and older and younger people with disabilities. Unlike Medicaid, it’s not means-tested. Beneficiaries pay part of the costs, including monthly premiums for Part B, which covers physician and other outpatient care. For 2018, that premium is $134.

However, people eligible for Medicare Savings Programs (MSPs) do not automatically qualify. In Florida, they must apply to the Department of Children and Families. Thousands of low-income Floridians are unaware of these programs and/or how to apply.

That’s when retroactive Medicaid eligibility (RME) kicks in, providing low-income Medicare beneficiaries a window during which they can apply. Under RME, coverage can go back three months prior to the month of application. For MSP applicants, this means an extra $402 benefit that would otherwise be deducted from their Social Security check— a sizable chunk for people living on less than $1,400 per month.

The state must get approval from the federal government before it can implement this cut. However, given the current administration’s willingness to let states waive (ignore) federal Medicaid law, it’s highly likely that Florida will get permission to move forward.

The best hope for stopping this proposal is at the state level. The Agency for Health Care Administration is accepting comments. The public needs to ask: When did lawmakers decide that low-income Florida Medicare beneficiaries are less deserving of the $402 benefit than those living in Georgia, Alabama or Texas?

ANNE SWERLICK, TALLAHASSEE Swerlick is an analyst at the Florida Policy Institute.