December 6, 2017

Legislators to rethink Medicare Savings Program cuts

John "Sean" Riccio sat on his power scooter outside the Legislative Office Building holding a large white sign that read "Please Don't Cut My Medicaid."

Riccio, 52, had driven to Hartford from his home in Suffield Monday to protest cuts to the state Medicare Savings Program that uses Medicaid money to help pay his Medicare costs.

The program's income eligibility limits were lowered with passage of the $41.3 billion state budget in October. The new income limits were supposed to go into effect on Jan. 1, but the Department of Social Services announced Wednesday it will slow down implementation of the changes in response to concerns raised by the enrollees, advocates and legislators.

According to DSS, agency officials will be reviewing coverage alternatives for the current enrollees and that this review process will take at least two months to complete, at which time the reduced limits will go into effect.

Riccio has multiple sclerosis and is among 171,500 low-income seniors and residents with disabilities currently enrolled in the state's Medicare Savings Programs. Roughly 86,000 will no longer be eligible for the program because of the rollback.

Administration officials said they still are developing projections for total enrollees affected, and warned Tuesday that forecast could grow. Riccio, along with all those likely affected by the changes, received a letter to that effect last month from DSS.

Since then, state legislators have been inundated with calls about the rollback and are now scheduled to meet Wednesday with Gov. Dannel P. Malloy to discuss it — along with what to do about the $207.8 million deficit already projected for the new two-year budget.

For some, the program pays for Medicare Part A and B premiums and out-of-pocket costs. The income eligibility limit for this coverage is currently $2,120 each month for a single person and $2,854 for a couple. As of Jan. 1, that drops by more than half to $1,025 per month for a single person and $1,374 for a couple.

For others, the program only covers the cost of their premiums. There are two income eligibility limits for this benefit, depending on whether the enrollee is covered by other Medicaid programs.

DSS projects roughly an additional 27,000 enrollees will move from one level of the program to another — meaning they will still get premiums paid, but not out-of-pocket costs, as of Jan. 1. Department officials are still determining the exact numbers in each level based on review of individual income data. Also, the final numbers may depend on federal funding allocations that are not yet determined.

According to the Office of Fiscal Analysis, the Medicare Savings Program changes will save about $20.4 million this fiscal year and $61.5 million in fiscal year 2019.

Riccio, who used to be a carpenter, was diagnosed with MS about eight years ago, and began collecting disability benefits about three years later.

His current monthly income of about $2,090 made him eligible this year for the most generous Medicare Savings Program — the one that covers his premium, which is about $140, as well as his out-of-pocket costs.

He's been eligible for the program on and off since he started receiving disability benefits.

"It was one less thing I had to worry about," he said Monday.

Riccio said he's trying to see as many doctors as possible this month, while he still has coverage. He has an infusion treatment scheduled for March he said he's worried about, since he doesn't know how it will be covered.

He said he plans to meet with a social worker this week to discuss purchasing a Medigap policy — private health insurance that helps pay for some costs not covered by Medicare.

"I understand this is real money [legislators are] talking about but you're hurting the most vulnerable people," he said. "If I could still walk, I would give a little more of my paycheck to help someone like me, someone like my friends, who are in power scooters all day."

For 27-year-old Jonathan Miller, who has cystic fibrosis, losing his Medicare Savings Program coverage means he's had to consider returning to work, sooner than he and his doctors would like, because it may make him eligible for another Medicaid program.

"I have to choose between risking my health, possibly my life, or else burden my family with what will likely add up to more than a $100,000 health bill over the years," Miller said. "It's a miserable feeling … Week-to-week, month-to-month, I do have situations that are life threatening. To add one more thing to focus on that isn't my health is a threat."

Cystic fibrosis is an incurable, genetic disease that causes persistent lung infections and limits the ability to breathe over time.

Miller, a resident of Meriden, worked for many years, but had to stop in November 2014 as his health deteriorated. He was approved for disability benefits and became eligible for the Medicare this year. He started receiving benefits from a Medicare Savings Program in June.

His monthly income is about $1,815, which includes his disability benefits and money he gets from a long-term disability plan from a previous employer.

Without the Medicare Savings Program, he predicted his health care costs could amount to half of his income, or more, each month because he would have to purchase additional health care coverage.

"What they are doing is awful, I hope they can review it and restore it to as many people as they can," he said.

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