STATE HOUSE – Rep. David Morales has introduced legislation (2023 H-5097) increasing the income eligibility threshold for seniors to be eligible for Medicaid. The bill aims to help seniors pay for medical needs that Medicare does not cover.

“This bill will help many older, lower-income Rhode Islanders afford needed prescription drugs and address health care services not covered by Medicare. Most importantly, this legislation addresses a major inequity in our Medicaid system by putting older persons on equal footing for income eligibility with other age groups,” said Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of RI.

Currently, most Rhode Island adults are eligible for Medicaid if they earn up to 138% of the federal poverty line (FPL). Rhode Islanders 65 or older, however, lose eligibility if they earn more than 100% FPL ($13,590 for an individual, $18,310 for a family of two). That leaves many lower-income seniors on the hook for expensive medical bills that they struggle to afford.

“Far too many of our neighbors face gaps in their health insurance coverage to no fault of their own,” said Representative Morales (D-Dist. 7, Providence). “It’s unfair that our state forces thousands of our lower-income seniors to pay out-of-pocket for critical medical services, such as dental care and prescription medicine. Oftentimes, Medicare coverage is not sufficient, especially for seniors on a fixed income, therefore, this is an issue of basic fairness. So, whether it is through passing this specific piece of legislation or securing an investment in the state budget, this must be the year that we expand Medicaid eligibility and ensure that none of our seniors get left behind. I look forward to advocating alongside my neighbors and advocacy organizations, such as the Senior Agenda Coalition of RI, because health care is a human right!”

While most seniors can obtain Medicare coverage starting at age 65, there are significant costs Medicare does not cover. Seniors who purchase Medicare Part B are eligible to buy supplemental plans or “Medigap” coverage, but these plans are cost-prohibitive for many. And without them, seniors are on the hook for thousands of dollars of deductibles, copays, and coinsurance if they need basic care. In addition, some services, such as dental, vision and long-term care, aren’t covered by Medicare at all, though they are covered by Medicaid in Rhode Island. This means that some low-income seniors on Medicaid lose important aspects of their coverage once they turn 65.