Budget Estimates for Selected Medicare Savings Program Reform Proposals

This paper provides estimates of the federal and state budgetary impacts of options for improving the Medicare Savings Programs (MSPs) and the Medicare Part D low-income drug subsidy. Among the options discussed are adopting uniform methods for counting certain income and assets, aligning MSP categories with drug subsidy categories, aligning categories and increasing resource limits, annuitizing liquid assets, eliminating estate recovery, and federally funding the entire Medicare Savings Programs. For additional options that could not be estimated, the paper summarizes the issues to be addressed and identifies potential data sources. The paper was prepared for the National Academy of Social Insurance’s Study Panel on Medicare/Medicaid Dual Eligibles.