More than 12 million people are eligible for both federal programs, and policy change is needed to enable these programs to work most effectively

Washington, DC—A diverse group of national stakeholders launched the Medicare-Medicaid Integration Alliance (MMIA) and announced cornerstone principles as a framework for federal and state policies that better support people dually eligible for Medicare and Medicaid.

Today’s announcement comes ahead of legislation expected in Congress to improve healthcare and services for more than 12 million people dually eligible for Medicare and Medicaid. This population includes older adults, those less economically secure, and people with disabilities.

Drawing on decades of research, case work, and advocacy, the consumer and health care organization members of the MMIA have identified the fragmentation of Medicare and Medicaid as a key barrier to care for the Medicare-Medicaid population. Individuals eligible for both programs regularly say they are unable to access the care and services they need, because they are forced to navigate two insurance programs that do not work well together. This lack of integration leads to care that’s difficult to understand and access. Medicare-Medicaid beneficiaries regularly say they have difficulty navigating both programs. The lack of coordination and efficiency also contributes to a more expensive system for taxpayers, resulting in $456 billion in spending in 2020.  

Calling upon research and interviews with Medicare-Medicaid beneficiaries, MMIA established three cornerstone principles intended to better support people dually eligible for the two programs, including:

1. Ensure people have access to meaningfully integrated coverage;
2. Support informed decision-making and easier enrollment in coverageby providing people with the necessary resources; and
3. Guarantee that integrated coverage is held accountable for meeting people’s needs and goals.

“Recent proposed updates to federal rules and the ongoing work of a working group in the Senate prove there is support amongst policymakers for bold action that advances integration, and it’s shared by leaders in both political parties,” said Mark Miller, executive vice president of health care at Arnold Ventures, a member of MMIA. “People who are dually eligible for Medicare and Medicaid live in every community across the country. This coalition wants to elevate and amplify their concerns so that policymakers act. It’s time to create a system of care that is cost-efficient, person-centered, and equitable for this important population.”

Congress and multiple Administrations have taken steps to improve integration of Medicare and Medicaid, yet results are uneven across states, and too few people who are dually eligible get the key aspects of care coordination they need, according to the MMIA.

“Helping people dually eligible for Medicare and Medicaid receive the care and services they need is essential to ensuring they’re healthy and that they remain connected to their communities,” said Amber Christ, managing director of health advocacy at Justice in Aging, a MMIA member. “It’s long past time to fix the inefficiencies inherent in dual eligibility for Medicare and Medicaid so we can focus on what really matters—the health and well-being of those dually enrolled in both programs.”

MMIA is composed of organizations that want to make health care work better for the people who need it most, including the millions of people eligible for both Medicare and Medicaid, and the providers who treat them. Founding members include Arnold Ventures, the Association for Community Affiliated Plans, Community Catalyst, Justice in Aging, and the Medicare Rights Center.

Learn more at MedicareMedicaidIntegration.org.