Enhancements to programs that protect low-income Medicare beneficiaries

(a) Elimination of resource standard for eligibility and enrollment determinations (1) LIS Section 1860D–14(a)(3)(A)(iii) of the Social Security Act (42 U.S.C. 1395w–114(a)(3)(A)(iii)) is amended by striking meets and inserting with respect to a plan year beginning before January 1, 2028, meets. (2) MSP Section 1905(p)(1)(C) of the Social Security Act (42 U.S.C. 1396d(p)(1)(C)) is amended by striking whose resources and inserting prior to January 1, 2028, whose resources. (b) Aligning eligibility criteria across MSP and LIS (1) LIS Section 1860D–14(a) of the Social Security Act (42 U.S.C. 1395w–114(a)) is amended— (A) in paragraph (1), in the matter preceding subparagraph (A), by inserting or, with respect to a plan year beginning on or after January 1, 2028, 200 percent after 150 percent; and (B) in paragraph (3)(A)(ii), by inserting (or, with respect to a plan year beginning on or after January 1, 2028, 200 percent after 150 percent. (2) MSP (A) In general Section 1905(p) of the Social Security Act (42 U.S.C. 1396d(p)) is amended— (i) in paragraph (1)(B), by inserting, except that, beginning with January 1, 2028, the methodology used in determining income eligibility under this subsection shall be no more restrictive than the methodology used by the Social Security Administration in making income determinations under section 1860D–14(a)(3)(C) after income program; and (ii) in paragraph (2)— (I) in subparagraph (A)— (aa) by striking shall be at least and inserting “shall be— (i) prior to January 1, 2028, at least; (bb) in clause (i), as added by item (aa), by striking the period and inserting; and; and (cc) by adding at the end the following new clause: (ii) on or after January 1, 2028, 200 percent of the poverty line applicable to a family of the size involved.; and (II) by adding at the end the following new subparagraph: (E) With respect to eligibility for medical assistance on or after January 1, 2028, in this paragraph, the definition of the term family of the size involved shall be no more restrictive than the definition of that term for purposes of section 1860D–14.. (B) Conforming amendments Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended— (i) in section 1902(a)(10)(E)— (I) in clause (iii), by striking for making and inserting prior to January 1, 2028, for making; and (II) in clause (iv), by striking subject to and inserting prior to January 1, 2028, subject to; and (ii) in section 1933(a), by striking A State plan and inserting Prior to January 1, 2028, a State plan. (3) Bidirectional eligibility deeming between MSP and LIS (A) LIS Section 1860D–14(a)(3)(B)(v) of the Social Security Act (42 U.S.C. 1395w–114(a)(3)(B)(v)) is amended to read as follows: (v) Treatment of medicaid beneficiaries Subject to subparagraph (F), the Secretary shall treat a part D eligible individual as a subsidy eligible individual described in paragraph (1) if they are— (I) a full-benefit dual eligible individual (as defined in section 1935(c)(6)); (II) a recipient of supplemental security income benefits under title XVI; or (III) determined for purposes of the State plan under title XIX to be eligible for medical assistance under section 1902(a)(10)(E)(i).. (B) MSP Section 1905(p) of the Social Security Act (42 U.S.C. 1396d(p)) is amended by adding at the end the following new paragraph: (7) Beginning January 1, 2028, a State shall provide that an individual described in paragraph (1)(A) who is a subsidy eligible individual described in section 1860D–14(a)(3) shall be treated as a qualified medicare beneficiary described in paragraph (1).. (C) Treatment of leads data (i) Transmittal Section 1144(c)(3) of the Social Security Act (42 U.S.C. 1320b–14(c)(3)) is amended by striking which transmittal shall initiate an application of the individual for benefits under the Medicare Savings Program with the State Medicaid agency and inserting which the State Medicaid agency shall treat as an application of the individual for benefits under the Medicare Savings Program consistent with section 1935(a)(4). (ii) Consideration by States Section 1935(a)(4) of the Social Security Act (42 U.S.C. 1396u–5(a)(4)) is amended to read as follows: (4) Consideration of data transmitted by the Social Security administration for purposes of medicare savings program (A) In general The State shall accept data transmitted under section 1144(c)(3) and— (i) in the case of an individual who is a subsidy eligible individual described in section 1860D–14(a)(3), promptly treat such individual as a qualified medicare beneficiary described in 1905(p)(1); and (ii) in the case of any other individual who is likely to be a qualified medicare beneficiary, as determined by the Secretary, act on such data in the same manner and in accordance with the same deadlines as if the data constituted an initiation of an application for benefits under the Medicare Savings Program (as defined for purposes of section 1144(c)(3)) that had been submitted directly by the applicant. (B) Date of application For purposes of subparagraph (A)(ii), the date of the individual's application for the low income subsidy program from which the data have been derived shall constitute the date of filing of such application for benefits under the Medicare Savings Program.. (D) Effective date The amendments made by this paragraph shall take effect on January 1, 2028.