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This week, as Senate Republicans continued to finalize their budget reconciliation bill, new KFF analysis underscores the harms it could cause older adults and people with disabilities.
KFF finds the bills would likely increase the financial burden associated with paying for Medicare Part B. In 2024, one in ten (12% or 7.4 million) Medicare beneficiaries spent more than 10% of their annual income on Part B premiums. This means they lived on $21,000 or less, based on the 2024 Part B premium amounts ($174.70/month).
Because the Medicare Savings Programs (MSPs) help cover Part B premiums and other costs, like deductibles and cost sharing, the financial burden for lower-income beneficiaries who are not enrolled in an MSP is particularly heavy. The upper income limit for MSP eligibility in 2024 was around $20,600 in most states. Some of the 7.4 million may not have qualified—they may have had income just above the eligibility cutoff or savings that made them ineligible for assistance. Some, though, may have been eligible but were not enrolled either because they didn’t know about the program or because signing up and keeping an MSP is administratively onerous.
By halting the rules designed to streamline these processes, the House and Senate reconciliation bills would cause more low-income people to lose MSP access and have trouble paying for Medicare.
By halting the rules designed to streamline these processes, the House and Senate reconciliation bills would cause more low-income people to lose MSP access and have trouble paying for Medicare. The Congressional Budget Office (CBO) projects nearly 1.4 million low-income people with Medicare—more than 10% of the dually enrolled Medicare-Medicaid population—would lose their MSP coverage due to the rollback of these simplifications. It is important to note that the streamlining rules do not change the MSP eligibility criteria – people would lose benefits solely because the application and re-certification processes would become more difficult to navigate.
Low-income beneficiaries who lose MSP would face significant costs as a result, both overall and as a share of their income. For example, the streamlining rules would automatically enroll people receiving Supplemental Security Income (SSI) into an MSP. People with SSI receive a maximum benefit of $967—reduced by any other income received in the month—and cannot have more than $2,000 in savings. The MSP into which they would be automatically enrolled under the rule, Qualified Medicare Beneficiary (QMB), has income and asset limits well above those amounts: $1,325 in non-work income and over $9,000 in savings. Despite their clear compliance with MSP eligibility rules, the Republican reconciliation bills would make people with SSI separately apply for the program, using the savings that would accrue when some of them fail to do so to pay for tax cuts that disproportionately benefit high income earners.
Despite their clear compliance with MSP eligibility rules, the Republican reconciliation bills would make people with SSI separately apply for the program.
But people with Medicare would pay the price. Without QMB, in 2025 SSI enrollees would pay about 20% of their monthly income to cover their Part B premium ($185). These financial burdens would grow with time, as annual Medicare Part B premiums are projected to reach nearly $2,500 in 2026 and more than $4,000 by 2034.
At the same time, other Medicare expenses would eat up even more of limited beneficiary budgets. For example, if these SSI enrollees paid the full annual Part A and Part B deductibles next year ($1,676 and $257, which would have been covered by QMB) their coverage costs would consume at least one-third of their annual SSI allocation. And because MSP enrollees automatically get the Part D Low Income Subsidy (LIS)/Extra Help, which helps pay for Medicare prescription drug coverage, they’d be on the hook for those costs too. The Social Security Administration estimates LIS saves enrollees about $6,200 per year, a number that is likely to rise as drug prices do.
Research consistently finds that people facing higher out-of-pocket costs for health care cut back on the care they receive, even if it is necessary for their health and safety. This leads to worse health, higher care needs, and more hospitalization—effects that drive up costs for individuals and system-wide. Losing Medicare cost assistance is also likely to increase mortality among low-income beneficiaries. The House bill’s streamlining rule delay “could result in 18,200 additional deaths among Medicare enrollees every year” primarily because “losing Medicaid also leads to the loss of prescription drug assistance through the Low-Income Subsidy (LIS) program.” The Senate bill goes further, prohibiting the implementation of the rule permanently.
Combined, LIS and MSPs make health care costs more manageable, allowing enrollees to maintain Medicare coverage, fill prescriptions, and afford basic needs like food and housing. Preventing more people from accessing the assistance for which they qualify will ensure that fewer people can use the Medicare coverage to which they are entitled. We urge Congress to reject the budget reconciliation bills and instead work together to improve the health and economic security of all Americans.
Preventing more people from accessing the assistance for which they qualify will ensure that fewer people can use the Medicare coverage to which they are entitled.
Despite the clear evidence that their bill will harm millions, Senate Republicans are not slowing down. They plan to vote as soon as this week. Since both chambers must pass an identical bill for it to become law, the House would then vote again. That could happen quickly, as Republicans are eyeing a July 4 deadline for final passage.
This rushed schedule means now is the time to go all in with your advocacy. Contact your lawmakers, activate your networks, attend events where your lawmakers will be present, and engage your local media. Weigh in today!
Read the KFF report, Seven Million People with Medicare Spend More Than 10% of Income on Part B Premiums – The Reconciliation Bill Could Drive the Number Higher
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10 Comments on “Senate Reconciliation Bill Would Increase Financial Hardships for Medicare Enrollees”
Cynthia Rockwell
June 27, 2025 at 2:10 amTell you what it’s all a crock o was in the hospital for just a few days receiving iv fluids. I got down on the floor and was unable to get back up.etc… my hospital bill was $183,000.00. what afraid abuse of charges. I didn’t want the body CT scan, nor the head CT scan nor the cervical scan. I wasnt wanting it. the techs wouldn’t take no for a answer because the Dr ordered it.well I know my health conditions better then anyone. Instead of taking to the patient was me I was exposed to a lot of radiation I didn’t need. I’ve accumulated more then anyone should in just a few years. My mother had acute radiation poisoning from medical test. No she wasn’t near a nuclear reactor meltdown. We’ve been lied to as always. She was given a poor prognosis to survive and we were told she should be put in a nursing home til herpassing. Easy for them to say it wasn’t their mom.. those scans that I was forced to have cost almost 30,000 dollars. What a rip off. Big pharma a joke charging us in the USA get do. You want us the low income to starve. I quit going to Drs because that can’t be trusted. The government has given illegals health insurance at our cost. Those illegals have committed a FEDERAL crime coming into our country illegally. But their rewarded you give them room and board, food, phones and now health insurance. 50 years ago we who lived in the farming communities and worked the farmland because we enjoyed it.. we were kicked out of all the jobs we had done for years. Because they were given to those that crossed the border daily. I don’t call MAGA the way your doing we the disabled low income citizens. Becoming disabled wasn’t my choice. Do whatever you want screws us that’s how it works anymore. Health insurance who needs it we can’t afford to go to Drs as it is. But he why would anyone want to when Drs aren’t trust worthy. I’ll just suffer til I pass.
John
June 27, 2025 at 9:37 amIf you are on Medicare you wouldn’t be charged armed that much and would only have a coinsurance. But you didn’t say what your coverage is which this is about. Sounds off base.
Elleen Dorr
June 29, 2025 at 1:10 pmIf you have regular Medicare, there’s no way your copays would be much as you say UNLESS you have already used all the days in your benefit period and the “extra” days. That’s really hard to do. And if your income/assets are at the bottom of the barrel, you should also be eligible for Medicaid which would pick up your copays at least.
Beverly J West
June 27, 2025 at 4:51 amThis “Beautiful Bill ” has so many flaws and misrepresentation, and has turned into one “Ugly MUTT”. Turned out by a bunch whom would rather die for there Lying Donald Trump for their wimm than than to compose this Bill with no cares as to appease him. There loyality to this lyer and 2 bit con man is just sickening. By passing this MUTT Bill will absolutely ruin any body that pays for their health care medicare supplement. I am on social security and I fall whereas my pay just gets me by and never miss my premium payment I do without to make sure it is pay. Plus do not qualify for any additional help. This situation is dire when the bills are just paid and have no groceries. I know others have nothing or not enough to get by. It’s like others will die according to this MUTT BILL it is actually sweeping us under the rug per say with no cares in their minds if as stated more or less the result they the MUTT will starve and slowly kill us with the help for the helplessness with their MUTT Bill they created just for their incompetent more holey than thou, he thinks, so they write the piece of crap to appease him. I ask, where were their minds?The house were the creator s of this piece of crap MUTT worthless Bill. This Bill resembles the acts of a crazy man that started in 1939 and resulting in WWII to dispose of a race of people. This Bill will destroy the poor and eventually destroy the former now retired seniors. Basically with the cuts to give and extend tax cuts, and to eventually sweep us under the rug. Cutting Medicade and programs set up to help the helpless and help the people who need it the most. With this Bill if passed it will devastate the poor the helpless, and the working class people. Just to give the billionaires a tax cut. In order words the worthless bill better Donald Trump so help him with his under the table cons. I ask how do you feel about this? Would you be devastated 💔 by the cuts that were made that helped you? What would you do to if your health care was ripped from your hands? Last but not least, what would you do if you Medicare supplement was no longer in you range of affordability? Like it is now the cost of a life saving surgery would send your in to bankruptcy real quick. Because the craziness cut out the benefits the programs that you have now, your suffering and being beat down now to save a buck and pay for tax cuts for billionaires. This fellow citizens is your house representatives who failed you the magas who wrote the MUTT Bill in the first place who dealt the full house to Trump because this Bill helps him not you. Now the Senate is trying to pass it the MUTT Bill and it is now stopped Rules were called by the Parliamentian. If The rotten bill passed 16 million people will loose their healthcare and people that make 55k will be poor off. If you have the ability to email your congress person and tell them how you feel.
Denise Early
June 27, 2025 at 1:40 pmDid I miss the part where the article says what the streamlined processes currently are? I re-read the article but did not see any mention of the current processes.
Medicare Rights Center
June 30, 2025 at 9:45 amThanks for reading! A good summary of what the streamlined MSP enrollment rules entail can be found at this link: https://www.medicarerights.org/medicare-watch/2023/09/21/important-final-rule-streamlines-enrollment-into-medicare-savings-programs
We’ve also added it as a hyperlink into the text of this article so future readers will have the information readily available.
Elleen Dorr
June 29, 2025 at 1:14 pmI don’t see how having to apply each year to keep EXTRA HELP in place is so terribly onerous. Medicare is an earned benefit. EXTRA HELP is an unearned benefit (i.e. welfare).
People are getting something for nothing and complain that they have to requalify annually to continue getting it.
Culture of dependency, over and over and over.
L. R.
June 29, 2025 at 6:01 pmI live in California, where people on Medicare and Medicaid already apply each year to keep their Extra Help (Medicaid) coverage. For a period of time during the COVID pandemic they did not need to reapply but currently they do.
Penelope
July 2, 2025 at 12:12 amI doubt people in the USA want to be dependent on welfare or medicaid. The amount of working poor tells a different story. Then there’s the middle class. Half of working Americans earn less than 75k a year. Wages have been stagnant for decades.Healthcare costs an average of14k per person/year.The cost of living continues to rise.
I’ll never forget the lines at the foodshelves in the first weeks of Covid!
Life is hard here in the USA. I believe most people struggle and they just might be woreout.
Perhaps people aren’t just lazy as you imply.
Aesop
July 7, 2025 at 12:10 amEver since January 6, 2021, I’ve been asking only one question: why is he NOT in PRISON?
Wherever law ends, tyranny begins ~ John Locke (1689)
= Welcome to the Banana Republic of America! =