Goodsurance
ES

Costs & IRMAA

Reconciliation Law Freezes a Rule That Would Have Made It Easier for Low-Income Seniors to Get Medicare Premium Help

A provision in the budget reconciliation law blocks a streamlined enrollment rule for Medicare Savings Programs until 2034, a change KFF says could affect more than 1.3 million low-income Medicare beneficiaries.

By the Goodsurance editorial teamJuly 17, 2026

The 2025 budget reconciliation law, signed into law last year, contains a provision that prevents the federal government from implementing a rule designed to simplify how low-income Medicare beneficiaries enroll in Medicare Savings Programs (MSPs) until October 1, 2034. A KFF analysis of the law's health provisions found that about 1.3 million people stand to lose Medicaid coverage of Medicare premiums and cost-sharing as a result.

Medicare Savings Programs are state-administered Medicaid programs that pay some or all of a beneficiary's Medicare premiums and, depending on the program tier, also cover deductibles, coinsurance, and copayments. They currently assist about 10 million Medicare enrollees, most of whom would otherwise pay the standard Part B premium, which is 185.00 dollars per month in 2026, entirely out of pocket.

A rule that would have made it easier for low-income seniors to get Medicare premium help is frozen until 2034.

The blocked rule had been finalized by CMS and was intended to streamline and simplify the enrollment and renewal process, making it easier for eligible people to join and stay enrolled. The reconciliation law's moratorium means those process improvements are shelved until 2034, leaving the more complex enrollment process in place.

Consumer advocates have noted that many low-income Medicare enrollees who qualify for MSP assistance do not receive it, partly because the application and renewal process can be burdensome. Suspending enrollment simplification for nearly a decade is expected to leave some eligible individuals without the premium and cost-sharing help they would otherwise receive.

In plain words

There are special programs, called Medicare Savings Programs, that help low-income people pay their Medicare costs. A rule was created to make it easier to sign up for these programs. But a new law passed last year puts that rule on hold until 2034. A study by KFF found that about 1.3 million low-income Medicare enrollees could miss out on help paying their Part B premium, which costs 185 dollars a month in 2026, and other costs because of this delay.

Source: KFF
Read at the source →

More news

Other stories on what is moving in Medicare.

Costs & IRMAA

Medicare Will Pay 20 Percent Less for the Cheaper Service When a Doctor Bills Both a Visit and a Procedure on the Same Day Starting in 2027

A provision in the final 2027 physician pay rule, published today in the Federal Register, trims reimbursement when a physician furnishes an office visit and a minor procedure on the same date. CMS projects the change will prevent approximately 2.38 billion dollars in extra Medicare payments over the next 10 years.

November 9, 2026

Costs & IRMAA

Medicare Finalizes 2027 Outpatient Rule, Cutting Drug Costs for Patients at Hospital Clinics

CMS issued a final rule November 4 that sets a 2.3 percent hospital outpatient payment increase for 2027 and lowers what Medicare pays hospitals for 340B-acquired drugs, projecting average savings of about 900 dollars for beneficiaries who receive a qualifying drug at a hospital outpatient department.

November 5, 2026

Costs & IRMAA

Nearly All Medicare Stand-Alone Drug Plan Members Will Face a Deductible in 2027, With Averages Up Sharply

A KFF analysis of 2027 Part D plan designs finds average deductibles rising to 643 dollars for stand-alone plan enrollees and 489 dollars for Medicare Advantage drug plan members, while the share of enrollees subject to any deductible expanded in both plan types.

October 30, 2026

Costs & IRMAA

CMS Finalizes 2027 Medicare Dialysis Payment Rate at 297 Dollars and 52 Cents, With a Larger Add-On for Home Dialysis Training

A final rule issued October 28 sets the per-treatment base rate for kidney dialysis facilities and raises the payment designed to encourage training patients to do dialysis at home.

October 29, 2026

Costs & IRMAA

Medicare's Hospital Fund Is Projected to Fall Short of Full Payment Capacity by 2033, Trustees Report Finds

The 2026 Medicare Trustees Report projects the Part A Hospital Insurance fund will be partially depleted in 2033, at which point incoming revenues would cover only 89 percent of covered costs, absent new legislation.

October 26, 2026

Costs & IRMAA

KFF: Nearly Half of Traditional Medicare Beneficiaries Hold Medigap, as Average Monthly Premiums Reach 244 Dollars

A KFF analysis released two days before open enrollment finds 12.9 million people carry supplemental Medigap policies, that average premiums rose 7 percent in a single year, and that Plan G now covers nearly half of all policyholders.

October 15, 2026