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Policy Work

The Medicare Rights Center’s policy agenda is driven by our experience serving people with Medicare and their families on our national helpline and through our educational programs. We pursue legislative and administrative solutions to protect, strengthen, and improve the Medicare program for current beneficiaries and generations to come.

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Issue-related resources

Policy Series

The resources provided here are based on insights shared through Medicare Rights’ national helpline. They offer detailed guidance on a variety of Medicare-related issues and include policy recommendations for improving the program in the short and long term.

What's at Stake

This series aims to explore various policy ideas and their potential impacts on major health care programs, such as Medicare, Medicaid, and the Affordable Care Act (ACA).
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Policy Recommendations for the Biden Administration

Read our recommended actions submitted for President Biden and his administration's consideration.

Medicare Advantage 101

This series helps individuals better understand Medicare Advantage and its role within the Medicare system.

Protect and Strengthen Medicare

This series highlights a variety of Medicare issues and provides policy solutions to improve the program now and in the future.
Hot Topics

Policy Issues

Informed by the thousands of stories we hear on our national helpline each year, our health equity-driven policy and advocacy agenda is focused on helping people with Medicare access and afford their care. The following issues are particularly pressing as we seek to advance these goals.

Medicare Advantage

People who choose Medicare Advantage (MA) face additional hurdles during the initial enrollment and annual plan selection processes. The MA plan choice landscape is cluttered, complicated, and confusing. Other MA features, like prior authorization, narrow provider networks, and predatory plan marketing, can worsen decision-making and access problems. It is also expensive. MA costs more, both overall and per enrollee, than Original Medicare. This drives up spending for the program, beneficiaries, and taxpayers; though little is known about how plans are using these dollars, or about overall plan quality. As MA enrollment grows, addressing its financing flaws and programmatic pitfalls becomes ever-more important. We support comprehensive reforms to ensure all beneficiaries can rely on their earned Medicare coverage.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.
Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Comments  |  
June 5, 2024  
Letters  |  
April 16, 2024  
Comments  |  
March 7, 2024  
Statements and Testimony  |  
November 1, 2023  
Tradoffs
Medicare Rights in the News  |  
October 12, 2023  
Positions and Publications  |  
July 17, 2023  
Positions and Publications  |  
July 17, 2023  
Coverage and Benefits

Medicare provides health coverage to over 60 million older adults and people with disabilities, paying for important medical care in hospital and outpatient settings. Nearly 12.5 million beneficiaries also rely on Medicaid, which helps with affordability through the Medicare Savings Programs (MSPs), and covers services Medicare does not, such as long-term services and supports. The Medicare Rights Center supports strengthening Medicare and Medicaid, modernizing benefits and financial assistance, and bolstering the workers and caregivers who deliver this vital care.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Positions and Publications  |  
July 1, 2024  
Statements and Testimony  |  
April 10, 2024  
CBS News New York
Medicare Rights in the News  |  
February 24, 2024  
Statements and Testimony  |  
September 27, 2023  
Comments  |  
March 13, 2023  
Times Union
Medicare Rights in the News  |  
March 6, 2023  
Medicare Part B Enrollment

Most people new to Medicare are automatically enrolled because they are receiving Social Security when they become eligible. But a growing number are not and must enroll on their own, taking into consideration specific timelines, intricate rules, and existing coverage. Mistakes are common and carry serious consequences, such as lifelong financial penalties, high out-of-pocket costs, disruptions in care, and gaps in coverage. Yet, few remedies are available to help beneficiaries correct honest missteps. The Medicare Rights Center supports reducing the likelihood of mistakes—including by simplifying the enrollment process and better empowering beneficiary decision-making—and improving relief opportunities for those who need them.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Prescription Drugs

The Inflation Reduction Act (IRA) takes important steps to reduce drug prices and lower costs for people with Medicare and the program, such as capping beneficiary out-of-pocket spending; requiring Medicare to negotiate drug prices; and expanding eligibility for the full Part D low-income subsidy (LIS). We support an implementation process that centers the beneficiary experience and look forward to building upon these landmark policies.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Denials and Appeals

Largely driven by prior authorization, MA and Part D coverage denials leave beneficiaries with only bad options: paying out-of-pocket, going without, or getting embroiled in a daunting and deeply flawed appeals process. Each path can lead to delayed care, abandoned therapies, worse health, and higher costs. Particularly egregious are improper coverage denials, which force people to make this choice unnecessarily. Changes are long overdue. Harmful denials must be curbed, and the appeals systems must be reformed to function as a safety valve—rather than as an inadequate substitute for sound plan decisions and robust federal oversight.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Comments  |  
March 13, 2023  
Positions and Publications  |  
January 20, 2021  
Positions and Publications  |  
December 17, 2020  
Positions and Publications  |  
July 31, 2019  
Positions and Publications  |  
July 31, 2019  
Medicare and Medicaid Integration

Distinct Medicare and Medicaid rules, funding streams, and service delivery systems can create barriers that increase costs and worsen outcomes for people who are jointly enrolled in the programs. We support correcting this fragmentation through policies that offer meaningful choice; reduce disparities in access to and quality of care; rely on active and informed enrollee participation; include robust safeguards and oversight; offer clear enrollee and provider education about options for accessing integrated care; establish unified grievance and appeals processes; ensure seamless access to data; and provide person-centered care coordination and care management.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more by reading Medicare Rights’ recommendations for New York integrated care products and toolkit for navigating integrated care in New York, as well as some of our recent comments:

Coverage and Benefits

Medicare provides health coverage to over 60 million older adults and people with disabilities, paying for important medical care in hospital and outpatient settings. Nearly 12.5 million beneficiaries also rely on Medicaid, which helps with affordability through the Medicare Savings Programs (MSPs), and covers services Medicare does not, such as long-term services and supports. The Medicare Rights Center supports strengthening Medicare and Medicaid, modernizing benefits and financial assistance, and bolstering the workers and caregivers who deliver this vital care.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Positions and Publications  |  
July 1, 2024  
Statements and Testimony  |  
April 10, 2024  
CBS News New York
Medicare Rights in the News  |  
February 24, 2024  
Statements and Testimony  |  
September 27, 2023  
Comments  |  
March 13, 2023  
Times Union
Medicare Rights in the News  |  
March 6, 2023  
Medicare Part B Enrollment

Most people new to Medicare are automatically enrolled because they are receiving Social Security when they become eligible. But a growing number are not and must enroll on their own, taking into consideration specific timelines, intricate rules, and existing coverage. Mistakes are common and carry serious consequences, such as lifelong financial penalties, high out-of-pocket costs, disruptions in care, and gaps in coverage. Yet, few remedies are available to help beneficiaries correct honest missteps. The Medicare Rights Center supports reducing the likelihood of mistakes—including by simplifying the enrollment process and better empowering beneficiary decision-making—and improving relief opportunities for those who need them.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Medicare Advantage

People who choose Medicare Advantage (MA) face additional hurdles during the initial enrollment and annual plan selection processes. The MA plan choice landscape is cluttered, complicated, and confusing. Other MA features, like prior authorization, narrow provider networks, and predatory plan marketing, can worsen decision-making and access problems. It is also expensive. MA costs more, both overall and per enrollee, than Original Medicare. This drives up spending for the program, beneficiaries, and taxpayers; though little is known about how plans are using these dollars, or about overall plan quality. As MA enrollment grows, addressing its financing flaws and programmatic pitfalls becomes ever-more important. We support comprehensive reforms to ensure all beneficiaries can rely on their earned Medicare coverage.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.
Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Comments  |  
June 5, 2024  
Letters  |  
April 16, 2024  
Comments  |  
March 7, 2024  
Statements and Testimony  |  
November 1, 2023  
Tradoffs
Medicare Rights in the News  |  
October 12, 2023  
Positions and Publications  |  
July 17, 2023  
Positions and Publications  |  
July 17, 2023  
Prescription Drugs

The Inflation Reduction Act (IRA) takes important steps to reduce drug prices and lower costs for people with Medicare and the program, such as capping beneficiary out-of-pocket spending; requiring Medicare to negotiate drug prices; and expanding eligibility for the full Part D low-income subsidy (LIS). We support an implementation process that centers the beneficiary experience and look forward to building upon these landmark policies.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Denials and Appeals

Largely driven by prior authorization, MA and Part D coverage denials leave beneficiaries with only bad options: paying out-of-pocket, going without, or getting embroiled in a daunting and deeply flawed appeals process. Each path can lead to delayed care, abandoned therapies, worse health, and higher costs. Particularly egregious are improper coverage denials, which force people to make this choice unnecessarily. Changes are long overdue. Harmful denials must be curbed, and the appeals systems must be reformed to function as a safety valve—rather than as an inadequate substitute for sound plan decisions and robust federal oversight.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more about Medicare Rights’ positions and recommendations from our policy documents:
Comments  |  
March 13, 2023  
Positions and Publications  |  
January 20, 2021  
Positions and Publications  |  
December 17, 2020  
Positions and Publications  |  
July 31, 2019  
Positions and Publications  |  
July 31, 2019  
Medicare and Medicaid Integration

Distinct Medicare and Medicaid rules, funding streams, and service delivery systems can create barriers that increase costs and worsen outcomes for people who are jointly enrolled in the programs. We support correcting this fragmentation through policies that offer meaningful choice; reduce disparities in access to and quality of care; rely on active and informed enrollee participation; include robust safeguards and oversight; offer clear enrollee and provider education about options for accessing integrated care; establish unified grievance and appeals processes; ensure seamless access to data; and provide person-centered care coordination and care management.

Read the latest news and updates on this issue. You can also stay on top of key Medicare policy and advocacy developments by subscribing to the weekly Medicare Watch newsletter.

Learn more by reading Medicare Rights’ recommendations for New York integrated care products and toolkit for navigating integrated care in New York, as well as some of our recent comments:

Fact Sheet

Protect & Strengthen Medicare

Informed by the stories heard on Medicare Rights’ national helpline, this fact sheet series highlights a variety of Medicare issues and provides policy solutions to improve the program now and in the future.

While it is relatively easy for a Medicare beneficiary to enroll into and disenroll from a Medicare Advantage (MA) plan on an annual basis, there are limited windows of opportunity to join a Medigap plan. This means that people who want to switch from MA to traditional Medicare may not have the option for supplemental coverage they need, which may lock them into MA coverage. In order for Medicare beneficiaries to have true freedom of choice concerning their coverage options, Medigap plan access must be strengthened.

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Medicare does not cover many of the essential services that older adults and people with disabilities need in order to live healthy lives. In addition to the direct impacts in terms of beneficiary well-being, gaps in access to these services can bring on or worsen other health concerns. Furthermore, this lack of coverage puts Medicare out-of-step with most private insurance and Medicaid which reflect a more modern understanding of patient needs and the interconnected nature of the human body.

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Current Medicare policies expose low- and moderate-income beneficiaries to excessive out-of-pocket costs. For those who qualify, the Low-Income Subsidy(LIS) program (also called “Extra Help”) can be a lifeline, helping them pay for Medicare coverage they would not otherwise be able to afford. But accessing this program presents challenges of its own. The application process is complex and fragmented, and the eligibility requirements are woefully outdated. As a result, many who need this assistance aren’t able to get it.

VIEW RESOURCE

Current Medicare policies expose low- and moderate-income beneficiaries to excessive out-of-pocket costs. For those who qualify, the Medicare Savings Programs (MSPs) can be a lifeline, helping them pay premiums and, in some cases, cost sharing for Medicare coverage they would not otherwise be able to afford. But the application process in most states is complex and burdensome, and the eligibility requirements leave far too many people who need this assistance unable to get it.

VIEW RESOURCE

Resource Library

Through public comments on administrative and regulatory changes, letters to policymakers, congressional testimony, and key reports, Medicare Rights advocates for systemic improvements to Medicare and other programs. Read these documents to learn more.

30 Policy Goals

Thinking ahead to Medicare's future, it’s important to modernize benefits and pursue changes that improve how people with Medicare navigate their coverage on a daily basis. Here are our evolving 30 policy goals for Medicare’s future.

Medicare Updates
Sign up for our weekly policy newsletter, Medicare Watch, to stay informed. Subscribers receive timely updates and alerts on issues important to older adults and people with disabilities. View recent articles in the latest news and updates.
Speak out

Take Action

Contacting your members of Congress is one of the best ways to enact positive change. Learn more about key legislation we’re following and weigh in today.

Working in Coalition

New York Advocacy

The Medicare Rights Center leads a number of coalitions designed to advocate for older adults, people disabilities, and people with limited incomes in New York.

The Coalition to Protect the Rights of New York’s Dually Eligible (CPRNYDE) is a diverse group of over 50 consumer-based interests, agencies, and perspectives working to shape the managed care programs that coordinate care for 760,000 older and disabled New Yorkers who are dually eligible for Medicare and Medicaid.

 

CPRNDYE, launched with support from Community Catalyst, seeks to improve the quality and affordability of care for New Yorkers dually eligible for Medicare and Medicaid. The coalition's membership engages in regular dialogue with state government and other stakeholders to improve programs intended to serve dual-eligibles. 

The New York State Medicare Savings Coalition, led by the Medicare Rights Center, is an alliance of over 150 community-based organizations, advocacy groups and government agencies in New York State. The Coalition is not intended for or open to employees of health insurance companies, health insurance agents or brokers, self-employed individuals, or individuals employed by private for-profit businesses. By bringing government officials and advocates together in dialogue, our meetings offer Coalition members the opportunity to review the latest information on implementing health care programs for people with limited incomes.

 

Coalition members stay connected through regular e-mail updates, conference calls, enrollment initiatives and advocacy projects. This ongoing exchange allows us to share knowledge about enrollment strategies and compare case scenarios.

CELEBRATING

YEARS

Join the anniversary celebration!

Let's continue making history

Help us honor 35 years of making Medicare more affordable, accessible, and equitable. Sign up to receive special alerts with ways to support our 35 years of service to older adults and people with disabilities. Learn more at www.medicarerights.org/35.