The undersigned national organizations, representing a variety of stakeholders, including providers and consumers, are writing to express strong support for including the following programs in any year-end health extenders package: the Qualified Individual (QI) program, the Transitional Medical Assistance (TMA) program, and Express Lane Eligibility (ELE) as well as the state incentive payment provisions and funding for quality improvement in the Children’s Health Insurance Reauthorization Act (CHIPRA).
Qualified Individual (QI) Program
Making the Qualified Individual (QI) program permanent is essential for low-income Medicare beneficiaries. QI pays Medicare Part B premiums for over 400,000 beneficiaries with incomes between 120 and 135 percent of the federal poverty level (about $13,700 to $15,500 per year for an individual) and limited assets (below about $7,080 for an individual). For 2013, the value of this assistance is more than $1,200 per person per year in premium savings alone. Moreover, because those with QI also automatically receive the Part D low-income subsidy, the value of the program is even more significant. The loss of QI would leave these beneficiaries with premiums approaching 10 percent of their incomes. As a result, many of them could be forced to drop their Part B coverage or face significant financial hardship. Moreover, making the program permanent will eliminate the uncertainty that beneficiaries and the states that administer QI have faced nearly every year as the program has approached expiration. A permanent QI program will be more stable and therefore better able to serve these vulnerable beneficiaries.
Transitional Medical Assistance (TMA) Program
We also request that you make the Transitional Medical Assistance (TMA) program permanent and align it with other Medicaid provisions. TMA provides temporary health care coverage to families that have lost Medicaid eligibility because they have found a job or received a wage increase from their employer yet cannot afford to purchase insurance in the private market. The GAO estimates that TMA extended vital coverage to over 3.7 million Americans in 2011. The National Governor’s Association deemed the program a ―crucial work support‖ because it protects families who are attaining financial self-sufficiency from incurring burdensome health care expenses. Furthermore, TMA will ease administrative burdens in states that have not expanded Medicaid by reducing ―churn‖ within health insurance markets. The program has enjoyed wide-ranging support in the past and has been extended multiple times on a bipartisan basis.