Medicaid pays Medicare cost-sharing expenses for many beneficiaries with both Medicaid and Medicare coverage, who are among the poorest and sickest Medicare beneficiaries. In response to analyses suggesting that lower Medicaid payment for Medicare cost sharing is associated with lower utilization by dually eligible beneficiaries relative to Medicare-only beneficiaries, this MACPAC staff presentation evaluates various policy options to assist dually eligible beneficiaries with their cost-sharing obligations.