Medicare Rights Advocates for Key Health Care Reforms in Congressional Budget Bill

In recent months, the Medicare Rights Center has been helping ensure that important health care reforms are included in the budget bill Congress hopes to pass this fall.

While Medicare and Medicaid provide critical coverage to millions of older adults and people with disabilities, gaps in eligibility and benefits, rising costs, and outdated and complex rules mean that far too many people with Medicare struggle to access and afford their care.

The budget bill, currently under development, presents lawmakers with an historic opportunity to address these needs. Medicare Rights is urging lawmakers to advance a bill that:

• Makes prescription drugs more affordable by allowing Medicare to negotiate drug prices, capping and smoothing beneficiary out-of-pocket drug costs, and restructuring the Part D benefit.

• Strengthens the Medicare benefit by adding comprehensive dental, vision, and hearing coverage to Part B; establishing a limit on beneficiary costs in Part D and program-wide; and expanding Medigap protections and purchase rights to all people with Medicare.

• Improves Medicaid coverage and care by making a $400 billion investment in Medicaid-funded home- and community-based services.

• Eases access to Medicare’s low-income programs by eliminating restrictive asset and eligibility tests for the Part D Extra Help program and Medicare Savings Programs (MSPs); raising the Qualified Medicare Beneficiary MSP income eligibility limit; and aligning program enrollment standards and administrative functions.

• Modernizes Part D appeals by strengthening data collection, transparency, and oversight; requiring independent redeterminations; allowing tiering exceptions and raising the specialty tier threshold; and improving plan communications with enrollees, including at the pharmacy counter.

Final decisions about the budget bill are expected soon. Please join us in urging Congress to include these commonsense solutions in the legislation. Enacting these policies would strengthen Medicare and Medicaid, as well as beneficiary health and economic security.

Tell your lawmakers that now is the time for transformational reforms and lasting change. Visit medicarerights.org/policy to take action.