People with Medicare Largely Forgotten in Spending Bill Debate

Washington, DC – We are relieved that Congress has reached an agreement to fund the federal government through February 8, as any lapse in federal funding can have serious consequences for people with Medicare and their families. We are also relieved that as part of this deal, Congress reauthorized the Children’s Health Insurance Program (CHIP), which provides affordable health coverage for over 9 million children in working families — many of which include people with Medicare.

However, we are concerned that key, bipartisan health policies were not addressed in this legislation. As Congress seeks to resolve outstanding spending and policy debates in the coming weeks, we urge lawmakers not to forget older adults and people with disabilities by overlooking the need to fund and extend these initiatives. The health and financial well-being of people with Medicare is at stake.

Without delay, we urge Congress to fully repeal the harmful Medicare therapy caps. These arbitrary caps create a barrier to accessing necessary therapy services, particularly for individuals with long-term, chronic conditions. The absence of such therapy can lead to avoidable health declines and permanent deterioration. To prevent these outcomes, the cap should be repealed or, at the very least, the process that has allowed individuals to seek an exception to the cap must be reinstated. A permanent fix is urgent to ensure that care is delivered to vulnerable patients, protects beneficiaries from high out-of-pocket costs, and safeguards the long-term viability of the Medicare program.

We also urge Congress to extend funding for community-based organizations to provide outreach and enrollment to low-income Medicare beneficiaries. Previous allocations for these critical activities have led to important, proven results, such as helping 2.5 million beneficiaries in need pay out-of-pocket health care costs they could not otherwise afford. Half of all people with Medicare—nearly 29 million older adults and people with disabilities—live on annual incomes of $26,200 or less, and one quarter live on $15,250 or less. Most people with Medicare simply cannot afford to pay more for health care, and without this assistance, many would be forced to go without care.

These policies have a long history of bicameral, bipartisan support and must be extended immediately. If not addressed soon, people with Medicare will face increased costs, reduced access to care, and decreased health and economic security. Congress must act now to protect and strengthen Medicare by funding and enacting permanent solutions for these vital health care extenders policies.

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