Rhode Island 2025 Regular Session

Rhode Island Senate Bill S0693 Compare Versions

Only one version of the bill is available at this time.

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5	5	2025 -- S 0693
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7	7	LC001222
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9	9	S T A T E O F R H O D E I S L A N D
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2025
12	12	____________
13	13
14	14	A N A C T
15	15	RELATING TO HUMAN SERVICES -- MEDICARE SAVINGS PROGRAMS
16	16	Introduced By: Senators DiPalma, Tikoian, Felag, Ciccone, DiMario, Britto, and
17	17	Thompson
18	18	Date Introduced: March 07, 2025
19	19	Referred To: Senate Health & Human Services
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22	22	It is enacted by the General Assembly as follows:
23	23	SECTION 1. The general assembly makes the following findings of fact: 1
24	24	(1) The Medicare Savings Programs (MSP) pay the monthly Medicare premium 2
25	25	($185/month in 2025) for eligible seniors and people with disabilities, increasing economic security 3
26	26	for those enrolled. 4
27	27	(2) The Medicare Savings Programs also pay Medicare cost-sharing (deductibles, 5
28	28	coinsurance and co-payments) for the lowest income enrollees, increasing access to care. 6
29	29	(3) The federal government sets minimum income and resource eligibility for the Medicare 7
30	30	Savings Programs. 8
31	31	(4) States are permitted to increase the income and resource standards; however, the 9
32	32	percentage increase in eligibility for higher income MSP enrollees must not be higher than the 10
33	33	percentage increase for lower-income enrollees. 11
34	34	(5) The federal government pays the full cost for higher-income MSP enrollees and over 12
35	35	half the cost for lower-income MSP enrollees. 13
36	36	(6) Individuals enrolled in MSP are automatically enrolled in the federally funded Part D 14
37	37	Low-Income Subsidy (Extra Help) program which helps pay prescription drug costs with average 15
38	38	savings for enrollees of five thousand three hundred dollars ($5,300) per year. 16
39	39	SECTION 2. Title 40 of the General Laws entitled "HUMAN SERVICES" is hereby 17
40	40	amended by adding thereto the following chapter: 18
41	41	CHAPTER 8.16 19
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45	45	MEDICARE SAVINGS PROGRAMS 1
46	46	40-8.16-1. Short Title. 2
47	47	This chapter shall be known and may be cited as the “Medicare Savings Programs”. 3
48	48	40-8.16-2. Purpose. 4
49	49	The Medicare savings programs, established in the Social Security Act, (42 U.S.C. 1396a), 5
50	50	§§ 1902(a)(10), 1905(p) and 1933, pay the monthly Medicare Part B premium for enrollees and 6
51	51	provide certain enrollees with help paying for out-of-pocket costs. For individuals who are disabled 7
52	52	and working, the program pays the Part A premium only. The programs are designed to improve 8
53	53	access to necessary medical services and to address financial insecurity of low-income Medicare 9
54	54	enrollees: people age sixty-five (65) and older and people with severe disabilities. States are 10
55	55	allowed to set income and asset limits for the Medicare savings programs that exceed the federally 11
56	56	mandated minimum levels. The federal government pays all or some of the costs for those enrolled 12
57	57	in the Medicare savings programs. The federally-mandated minimum eligibility is too low to 13
58	58	adequately address the needs of thousands of needy Rhode Islanders age sixty-five (65) and older 14
59	59	and people with severe disabilities. It is the intent of the general assembly to increase eligibility 15
60	60	for the Medicare savings programs consistent with federal law and as long as federal cost-sharing 16
61	61	is provided. 17
62	62	40-8.16-3. Definitions. 18
63	63	As used in this chapter: 19
64	64	(1) "Income” means the income of the family unit of an individual as determined by the 20
65	65	income-counting rules used for determining eligibility for federal Supplemental Security Income 21
66	66	benefits under title XVI of the Social Security Act, 42 U.S.C. 1396a. 22
67	67	(2) “Medicare Part A” means the program established under Part A of title XVIII of the 23
68	68	Social Security Act. 24
69	69	(3) “Medicare Part B” means the program established under Part B of title XVIII of the 25
70	70	Social Security Act. 26
71	71	(4) “Medicare savings programs” and “Medicare premium payment programs” mean, 27
72	72	collectively, the state-administered programs described in § 40-8.16-4. 28
73	73	(5) “Qualified disabled and working individual” means an individual who is not otherwise 29
74	74	eligible for medical assistance; who is entitled to enroll in hospital insurance benefits under section 30
75	75	1818A of Title VIII of the Social Security Act; whose income does not exceed two hundred percent 31
76	76	(200%) of the federal poverty line applicable to the person’s family size; and whose resources do 32
77	77	not exceed twice the maximum amount that an individual (or a couple, in the case of a married 33
78	78	individual) may have and obtain federal supplemental security income benefits under title XVI of 34
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82	82	the Social Security Act. 1
83	83	(6) “Qualified individual” means an individual who is not otherwise enrolled in medical 2
84	84	assistance and who is entitled to hospital insurance benefits under part A of title XVIII of the Social 3
85	85	Security Act whose income is greater than one hundred thirty-eight percent (138%) but less than 4
86	86	or equal to one hundred eighty-six percent (186%) of the federal poverty line applicable to the 5
87	87	person’s family size. Insofar as federal financial participation is available, an individual’s resources 6
88	88	shall not be considered in determining whether an individual is a qualified individual. 7
89	89	(7) “Qualified Medicare beneficiary” means an individual who is entitled to hospital 8
90	90	insurance benefits under part A of title XVIII of the Social Security Act whose income does not 9
91	91	exceed one hundred thirty-eight percent (138%) of the federal poverty line applicable to the 10
92	92	person’s family size. Insofar as federal financial participation is available, an individual’s resources 11
93	93	shall not be considered in determining whether an individual is a qualified Medicare beneficiary. 12
94	94	(8) “Resources” means the resources of the family unit of an individual as determined by 13
95	95	the resource-counting rules used for determining eligibility for federal Supplemental Security 14
96	96	Income benefits under title XVI of the Social Security Act. Insofar as federal financial participation 15
97	97	is available, resources shall not be considered in determining an individual’s status as a qualified 16
98	98	Medicare beneficiary or qualified individual. 17
99	99	(9) “Secretary” means the secretary of the executive office of health and human services. 18
100	100	40-8.16-4. Payments. 19
101	101	(a) The state shall provide for enrollment in Medicare Part B, and shall make payments for 20
102	102	the Medicare Part B premium and any Medicare Part A premium, as well as for other Medicare 21
103	103	cost-sharing including co-insurance and deductibles, for any individual who is a qualified Medicare 22
104	104	beneficiary. 23
105	105	(b)(1) To the extent that federal financial participation is available at a one hundred percent 24
106	106	(100%) federal medical assistance percentage and subject to §§ 1933 and 1902(a)(10)(E)(iv) of the 25
107	107	Social Security Act, the state shall provide for enrollment in Medicare Part B, and shall make 26
108	108	payments for the Medicare Part B premium, for any individual who is a qualified individual. 27
109	109	(2) Premium payments for qualified individuals will be one hundred percent (100%) 28
110	110	federally funded up to the amount of the federal allotment. The secretary of health and human 29
111	111	services shall discontinue enrollment into the program when the Part B premium payments made 30
112	112	pursuant to subsection (b)(1) of this section meet the yearly federal allotment. 31
113	113	(c) The state shall make payment for the Medicare Part A premium for any individual who 32
114	114	is a qualified disabled and working individual. 33
115	115	40-8.16-5. Application process and outreach. 34
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119	119	The secretary shall ensure that an individual’s data in an application for the Low-Income 1
120	120	Subsidy (LIS) program that is transmitted by the Social Security Administration to the executive 2
121	121	office of health and human services is used to begin the process of application for said individual’s 3
122	122	eligibility as a qualified Medicare beneficiary or qualified individual. The secretary shall maintain 4
123	123	a simplified application form, consistent with federal law for enrollment into these programs, for 5
124	124	application by individuals whose application is not started by transmission of LIS information from 6
125	125	the Social Security Administration. The secretary shall publicize the availability of the Medicare 7
126	126	savings programs. 8
127	127	40-8.16-6. Federal approval and implementation. 9
128	128	The secretary shall submit any necessary amendments to the Medicaid state plan or the 10
129	129	1115 waiver to implement the provisions of this section. 11
130	130	40-8.16-7. Rules and regulations. 12
131	131	The secretary shall make and promulgate rules and regulations not inconsistent with state 13
132	132	law, pursuant to chapter 35 of title 42 ("administrative procedures") as the secretary deems 14
133	133	necessary for the proper administration of this chapter and to implement the policy and purposes 15
134	134	thereof, and to ensure conformance to the provisions of the Social Security Act, 42 U.S.C. § 1396 16
135	135	et seq., and to any rules or regulations promulgated pursuant thereto. 17
136	136	SECTION 3. This act shall take effect upon passage. 18
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143	143	EXPLANATION
144	144	BY THE LEGISLATIVE COUNCIL
145	145	OF
146	146	A N A C T
147	147	RELATING TO HUMAN SERVICES -- MEDICARE SAVINGS PROGRAMS
148	148	***
149	149	This act would expand eligibility for the qualified Medicare beneficiary program by 1
150	150	increasing the income limit from one hundred percent (100%) to one hundred thirty eight percent 2
151	151	(138%) of the federal poverty line and expand eligibility for the qualified individual program by 3
152	152	establishing an income limit of one hundred thirty eight percent (138%) to one hundred eight six 4
153	153	percent (186%) of the federal poverty line. There would be no asset limit applied to eligibility for 5
154	154	these programs. 6
155	155	This act would take effect upon passage. 7
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