As the government shutdown continues, so do its impacts on older adults, people with disabilities, and their families. While Medicare and Medicaid are fully funded for the year, other critical programs—like affordable housing, food assistance, and transportation services—are not. This threatens the health and economic security of millions of Americans.

In November, the Centers for Medicare & Medicaid Services proposed regulatory changes to the Affordable Care Act’s Health Insurance Marketplaces. We submitted comments this week, in which we raise concerns with several aspects of the proposed rule that could have negative implications for people with Medicare.

CMS indicates it is proposing this rule in part to ensure that people are in the “most appropriate type of coverage.” While Medicare Rights supports this goal, we disagree with the agency’s proposal to achieve it by automatically terminating Marketplace coverage for people who are eligible for or enrolled in Medicare Part A.

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released a Dear State Medicaid Director letter highlighting ten opportunities for states to better serve individuals dually eligible for Medicare and Medicaid.

Medicaid is an important source of coverage for nearly 12 million people with Medicare. It covers needed services that Medicare does not, such as long-term care. Medicaid also helps make Medicare more affordable by helping pay Medicare premiums and/or cost-sharing, which can be high for people with low incomes.

On Tuesday, the U.S. House of Representatives passed the IMPROVE Act (H.R. 7217), which extends two critical Medicaid programs for older adults and people with disabilities. The U.S. Senate is expected to approve the bill before adjourning for the year.

First authorized in the Deficit Reduction Act of 2005, the Medicaid Money Follows the Person Demonstration Program (MFP) officially launched in 2007. Since then, it has helped over 88,000 older adults and people with disabilities transition from nursing and other facilities back to the community, and it has consistently been a cost-effective, successful program. According to independent, national evaluations MFP participants who have transitioned to community-based settings experience lasting improvements in quality of life, and they also decrease their overall Medicare and Medicaid expenditures by roughly 23%, generating considerable cost savings for the programs.

Earlier this month, the Medicare Rights Center and the Center for Medicare Advocacy sent a letter to the Centers for Medicare & Medicaid Services (CMS) expressing concerns with some of the agency’s Fall Open Enrollment education and outreach materials. These materials seem to promote Medicare Advantage (MA) over Original Medicare.

This week, lawmakers returned to Washington for the “lame duck” session, where they face a variety of issues to resolve before the end of the year. A lame duck session occurs when Congress reconvenes after an election, and is a reference to the outgoing members who still have voting powers.

The lame duck outlook for health care programs is somewhat uncertain, but lawmakers will have several opportunities to protect and strengthen programs for older adults and people with disabilities. In the coming days, we’ll be asking Congress to prioritize Medicare, Medicaid, and the Affordable Care Act.

The 2018 midterm elections mean big changes are coming to Washington. When the 116th Congress convenes in January, it will be a divided one: Republicans will continue to control the Senate, but Democrats will have a majority in the House of Representatives for the first time in eight years.

With split-party control, any legislation will require bipartisan support in order to pass. The need for such consensus greatly decreases the likelihood that radical, disruptive bills will reach the President’s desk in the coming years, and effectively eliminates the acute threats to Medicare, Medicaid, and the Affordable Care Act (ACA) that have dominated congressional conversations since 2017.

While most people newly eligible for Medicare are automatically enrolled in the program because they are receiving Social Security benefits at age 65, a growing number are not—and can face significant challenges in knowing how and when to do so. A recent article in The New York Times, “Why You Shouldn’t Wait to Sign Up for Medicare Part B,” highlights these complexities through the experience of Mr. Zeppenfeldt-Cestero, whose mistake in delaying Part B triggered punitive financial penalties and harmful coverage gaps.

The article also focuses the BENES Act (S.1909/H.R. 2575), in particular that it would help prevent enrollment mistakes by modernizing and simplifying the Part B enrollment process, and by sending notices to people who are approaching age 65 that clearly explain Part B enrollment.

While Medicare Advantage (MA) plans are required to cover the same health services as Original Medicare, they are not required to offer the same level of provider access and can impose coverage restrictions—like prior authorization—that require enrollees to take additional steps before accessing prescribed care. If a service is covered “with prior authorization,” enrollees must get approval from the plan prior to receiving the service. If approval is not granted or sought, the plan generally will not cover it.

The Centers for Medicare & Medicaid Services (CMS) recently announced a year-long extension, through September 30, 2019, of a critical relief pathway for current and former Marketplace enrollees who mistakenly delayed Medicare enrollment. The agency also agreed to develop a more permanent solution for people who are affected.

Under this policy, people who are eligible for Medicare and have Marketplace coverage can apply to enroll in Medicare Part B without penalty. Those who have already transitioned to Medicare can request that any Part B late enrollment penalties they may have received be reduced or eliminated.