This session previewed a draft chapter on the Medicare Savings Programs (MSPs). This chapter describes the MSPs and their role in providing Medicaid assistance with Medicare premiums and cost sharing to individuals who are dually eligible for Medicaid and Medicare. It begins by providing an overview of the MSPs, and then discusses MACPAC’s prior work analyzing participation rates in the MSPs. In 2017, we contracted with the Urban Institute to estimate participation in each of the MSPs. We found relatively low participation in the qualified Medicare beneficiary (QMB) program, the MSP with the most enrollment, at around 50 percent. Subsequently, the Commission made recommendations aimed at improving participation in the MSPs.
The policy landscape has changed considerably since our 2017 analysis prompting interest in an up-to-date look at the MSPs. Because of challenges associated with obtaining the data to conduct the study of participation, we could not easily update that analysis. Instead, we examined enrollment trends to see what we could infer about how participation may have changed. We once again contracted with the Urban Institute, this time to analyze enrollment in each of the MSPs, using Medicare administrative data for calendar years 2010 through 2021. The draft chapter concludes with our new analysis of enrollment trends, including comparisons across MSPs. The analysis includes comparisons of enrollment trends by demographic characteristics including age, sex, and urban or rural residence.