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Costs & IRMAA

Seven Million Medicare Enrollees Spend More Than 10 Percent of Their Income on Part B Premiums

A KFF study finds a large share of Medicare enrollees with modest incomes already face a disproportionate Part B premium burden, and the reconciliation law's Medicaid cuts could push more people into that group.

By the Goodsurance editorial teamJuly 11, 2026

About seven million people enrolled in Medicare spent more than 10 percent of their annual household income on Part B premiums in 2024, according to a KFF analysis. The group had per capita annual income of 21,000 dollars or less, and the 2024 standard monthly Part B premium of 174.70 dollars represented a heavy share of their budgets. For 2026, that standard monthly premium has risen to 202.90 dollars.

Medicare Savings Programs, administered through Medicaid, help lower-income beneficiaries by covering Part B premiums and certain cost-sharing obligations. KFF warns that provisions in the budget reconciliation law signed July 4, 2026, which tighten Medicaid enrollment requirements, could lead to more low-income Medicare beneficiaries losing access to those subsidies.

Seven million Medicare enrollees spend over 10 percent of their income on Part B premiums alone, and new Medicaid cuts put their premium assistance at risk.

Before the law was enacted, the Congressional Budget Office estimated that Medicaid enrollment changes in the bill could cause more than a million Medicare beneficiaries to lose Medicare Savings Program benefits. The final provisions in the enacted law may differ from pre-passage projections.

KFF's analysis notes that original Medicare has no general limit on out-of-pocket spending, making supplemental programs such as Medicare Savings Programs a critical backstop for beneficiaries who cannot afford Medigap or Medicare Advantage coverage.

In plain words

About seven million people on Medicare spend more than 10 cents of every dollar they earn on their Part B insurance premium. Most of them earn 21,000 dollars a year or less. In 2026, the Part B premium is 202.90 dollars a month. Programs called Medicare Savings Programs help pay this cost for people who qualify. But a new law signed July 4 could make it harder for some people to keep that help. Health researchers warned that before the law was signed, more than a million Medicare enrollees could lose this assistance. If that happens, those people would have to pay the full Part B premium on their own.

Understand the basics first

Source: KFF
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