New Model Policies Seek to Simplify Medicare Savings Program Access

The Aging & Disability Health Policy Lab, a new venture supported by The SCAN Foundation, has drafted four model policies for states to simplify access to the Medicare Savings Programs (MSPs). The Lab is seeking feedback by July 10.

Administered by state Medicaid offices, the MSPs provide a financial lifeline for low-income Medicare enrollees by paying their Medicare Part B premiums ($202.90 per month in 2026) and enrolling them in Extra Help, the federal prescription drug subsidy program that the Social Security Administration (SSA) estimates is worth about $5,700 per year. Combined, these programs save enrollees an estimated $8,000 annually, allowing them to maintain Medicare coverage, afford medications, and better meet daily living expenses like food and housing.

Despite these successes, MSP uptake is far too low. This is due to several factors, including overly restrictive eligibility rules that lock out many who are struggling. Even those who qualify face barriers—millions who are eligible for this assistance are not getting it. People may not know about the program or how to sign up, and those who do may be derailed by its notoriously complex enrollment process. Taken together, an estimated 40% of those who are eligible are missing out on important MSP benefits.

The Medicare Right Center Supports Modernizing MSP Access

Boosting MSP uptake is a long-standing goal of the Medicare Rights Center. To make it clear what a difference this assistance can have in the lives of older adults and people with disabilities, and to support advocacy efforts to expand MSP eligibility and enrollment, in 2025 we compiled a set of case studies from our national helpline. Those real-world experiences highlight the obstacles beneficiaries commonly face when trying to get and keep an MSP and underscore the importance of the program.

We also have a long history of identifying state level interventions to ease MSP access. In New York, we advocated for an MSP eligibility expansion that is helping nearly 300,000 more New Yorkers get these vital benefits. We also worked to advance legislation automating MSP enrollment for people with Extra Help, using information already on file with SSA. This modernized approach reduces entry barriers for New Yorkers and administrative burdens on state agencies, making the system more efficient and equitable.

At the federal level, we have also supported simplification efforts, including rulemaking to streamline MSP enrollment nationally. These changes were initially estimated to increase MSP uptake by at least 860,000, but were blocked by the 2025 reconciliation bill, HR 1, to reduce the bill’s costs and pay for other priorities.

The Congressional Budget Office (CBO) projects nearly 1.4 million low-income people with Medicare will lose MSP and Extra Help as a result. While CBO’s report anticipates this will yield $162 billion in savings, their analysis does not include important realities likely to undercut those amounts: Research demonstrates that when beneficiaries cannot afford care, they delay or skip important treatment, driving up health needs and spending in the long run.

There is also a very real human cost to anemic and curtailed MSP enrollment. A 2025 study in the New England Journal of Medicine links losing Medicare cost assistance with significant increases in mortality. Its authors issued a memo applying that research to HR 1’s MSP streamlining rule delay, warning it “could result in 18,200 additional deaths among Medicare enrollees every year.”

Help Shape Future MSP Policy

Recognizing the value of a strong MSP benefit, the Aging & Disability Health Policy Lab’s newly released model policies are designed to help states consider and adopt improvements.

The MSP model policies are the Lab’s first major policy effort, signaling the issue’s importance. They acknowledge state headwinds, but note that MSP improvements are not incompatible with budgetary and health care goals: “While states face multiple demands and financial challenges, simplifying access to the MSPs can reduce administrative costs while improving health care for Medicare beneficiaries.”

The proposals give states a framework to lower beneficiary costs, simplify MSP enrollment, recognize caregiver needs, and update eligibility rules. The Lab provides detail on each policy direction, including model legislation and analysis. Several of the models build on New York reforms championed by Medicare Rights, including those to eliminate the asset test and flatten the benefit cliff from Medicaid to Medicare.

The Lab is inviting the public to review the proposals and submit feedback by July 10. The Medicare Rights Center will be weighing in, and we look forward to future engagement with stakeholders and policymakers on this vital topic.

For More Information

Medicare Savings Programs: A Lifeline for Millions: Policy Recommendations from the Medicare Rights Center

Public comments on the Aging & Disability Health Policy Lab model policies are open through July 10. Click here to review the proposals and submit feedback.