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Federal Program That Helps Patients Navigate Medicare May Be Cut

A program that has helped seniors understand the many intricacies of Medicare, as well as save them millions of dollars, would be eliminated by a budget bill overwhelmingly approved last week by the powerful Senate Appropriations Committee.

The State Health Insurance Assistance Program, or SHIP, is among more than a dozen programs left out of the bill by the committee. Cutting these "unnecessary federal programs" helped provide needed funding for other efforts, Sen. Roy Blunt, a Republican from Missouri, said in a statement issued last week. Blunt is chairman of the Appropriations Committee's health and labor subcommittee.

Ending SHIP saves $52 million — which will help pay for a $2 billion increase for the National Institutes of Health, restore year-round Pell Grants for college students, and increase resources to prevent and treat opioid abuse, among other things.

"Seniors should absolutely have access to high-quality, personal customer service as they seek Medicare benefits," said an aide to Sen. Patty Murray of Washington, who is the senior Democrat on the labor and health subcommittee. "Sen. Murray is disappointed that within the tight budget constraints, we were unable to do more to ensure that is the case." The aide said Murray is hopeful she can restore funding.

SHIP counselors are in every state, the District of Columbia and the U.S. territories. These counselors offer Medicare beneficiaries free advice on how to choose from an array of drug and health insurance plans and how to challenge coverage denials. They advise Medicare patients how to get financial subsidies for premiums, co-payments and deductibles. They provide one-on-one counseling, as well as host enrollment clinics, informational meetings, special "Welcome to Medicare" events for new beneficiaries, and answer questions over toll-free telephone help lines.

"Medicare is very complicated," said Howard Bedlin, vice president for public policy and advocacy at the National Council on Aging, a nonprofit service organization. "Last year SHIPs helped 7 million people navigate this program and without those services, people will not be able to make well-informed choices. That's going to cost them money."

On Thursday, the council, along with the Center for Medicare Advocacy, Medicare Rights Center and National Committee to Preserve Social Security and Medicare, called on Senate leaders to restore SHIP.

The full Senate is expected to vote on the budget bill in the fall, and then it would have to be reconciled with a version from the House, which has not yet drafted its bill.

In April, more than 43 groups urged congressional leaders to increase SHIP funding to keep pace with inflation and the growing Medicare population, which adds 10,000 baby boomers each day.

Ohio's SHIP program saved seniors $20.8 million in 2015 and was ranked first in the nation by the Department of Health and Human Services, according to the state's lieutenant governor. It received $1.84 million in federal funding for the 12-month period ending March 31.

California's SHIP program, known as the Health Insurance Counseling and Advocacy Program (HICAP), has also helped beneficiaries save money. In Orange County alone, 1,247 beneficiaries saved an estimated $1.17 million last year when SHIP counselors showed them, among other things, how to switch to drug plans that covered their medications, said Linda Walton, the county's HICAP program manager.

"We have this huge influx of people turning 65 and they are cutting the program that helps this population find benefits they need?" said Bonnie Burns, a training and policy specialist who trains HICAP counselors. "That makes absolutely no sense."

Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.

Copyright 2023 Kaiser Health News. To see more, visit Kaiser Health News.

Susan Jaffe