Letter to the editor: Medicare now more affordable

Thank you, legislators, for listening to Vermonters’ voices and improving Medicare affordability.

This year, low-income Vermonters on Medicare shared their stories about struggling to afford health care and other basic needs and implored the Legislature for help. One Vermonter described their transition onto Medicare:

“The premiums are more with much less coverage. I just don’t go to the doctor anymore because of the deductible and copays. I never know what they will be and can’t take the chance.”

Until this year, many policy makers were unaware of the “Medicare Cliff” — the precipitous drop in financial support and access to care for people on Medicare (older adults and people living with a disability). But low-income Vermonters have known about it for years because of their lived experience of losing coverage and having to pay more when transitioning onto Medicare.

During the past legislative session, the Office of the Health Care Advocate and partner organizations worked tirelessly to amplify Vermonters’ voices and suggest ways that policymakers could help. As the State Health Care Advocate, I noted that once legislators understood the options in front of them, they stepped up to the plate and did what they could during this very tight budgetary year to improve the lives of some of our most vulnerable Vermonters.

Thanks to the Legislature’s actions, as early as Jan. 1, 2026, Vermont will extend eligibility for its Medicare Savings Program (MSP) to an additional 12,000 Vermonters. It is anticipated that people on Medicare with annual incomes up to $29,367 (if single) and $39,858 (if married) will qualify.

The MSP provides a crucial lifeline for older adults and people living with a disability, allowing them to afford health care and keep more of their hard-earned Social Security income to spend on basic needs like housing, food, and medicine. While the expansion will cost the state $4.7 million, it’s a smart investment with an estimated return of bringing $48.1 million in savings and benefits to Vermonters each year:

• An additional 12,000 Vermonters will get to keep $2,096 in their pockets each year because this expansion will pay their Medicare Part B premiums. The total value of this new benefit is close to $25 million per year for some of the most vulnerable Vermonters living in our communities. This will act as an ongoing economic stimulus for older adults and people with disabilities.

• An additional 10,000 of the lowest-income Vermonters on Medicare will have their copays and deductibles covered. By covering copays and deductibles for Medicare Part A (hospital) and Part B (medical) services, legislators have ensured these Vermonters can get the health care they need, when they need it, and that providers are compensated for this care.

• An estimated 3,769 Vermonters will qualify for financial help with prescriptions for the first time. This benefit will be 100% federally funded through the Low-Income Subsidy (LIS).

This is a phenomenal victory for Vermonters who are enrolled in Medicare (older adults and people living with a disability), who have long been subject to the lowest level of financial support of any population when accessing health care.

There are too many legislators to thank everyone by name here, but we want to give a particular shout out to local Senator Ruth Hardy, as well as Representatives Diane Lanpher, Robin Scheu, and Mari Cordes for their leadership on this issue. Their efforts were an important part of this success. We also appreciate the House Health Care Committee and its leadership for getting the ball rolling, the Senate Health & Welfare Committee and the leadership of both the House and Senate Appropriations Committees for recognizing this was a priority even during a very tough budget year.

With appreciation, on behalf of low-income Vermonters on Medicare, we wanted to pause and thank legislators for a job well done this year!

Mike Fisher of Lincoln & The Office of the Health Care Advocate

The Office of the Health Care Advocate (HCA) is here to help answer your questions! The HCA is a free resource available to help all Vermonters resolve their health care problems. Call 1-800-917-7787 or email [email protected] to speak with a Health Care Advocate or visit us on the web at https://vtlawhelp.org/health.

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