Smiling child

Save Our SHIP – Senate Appropriations Committee May Cut All Funding for the State Health Insurance Assistance Program (SHIP)

The U.S. Senate Appropriations Committee introduced a budget for federal fiscal year (FY) 2017 cutting all funding ($52.1 million) for the State Health Insurance Assistance Program (SHIP).

The State of Wisconsin currently receives about $1 million annually through the federal SHIP grant. This funding is used to support the:

• Toll-free statewide Medigap Helpline and Medigap Part D and Prescription Drug Helpline operated by the Board on Aging and Long Term Care (BOALTC);

• Toll-free statewide Medicare Part D Helpline operated by Disability Rights Wisconsin (DRW) for people with disabilities and their families or guardians;

• Elder Healthcare Advocate (an attorney specializing in eligibility and transitions for BadgerCare Plus, the Health Insurance Marketplace and Medicare) at the Greater Wisconsin Agency on Aging Resources (GWAAR); and

• Elder Benefit Specialist services in 72 counties and 11 tribes.

In 2015, staff working in these programs and services responded to over 95,000 contacts with Medicare beneficiaries and conducted over 2,600 public outreach events during that same period. 

Over 5,100 callers were referred to a Wisconsin SHIP counselor by the Centers for Medicare & Medicaid Services (CMS)/1-800-MEDICARE or medicare.gov, and another 13,000 were referred from another agency such as Social Security. The collaboration between the Aging and Disability Resource Centers, Disability Rights Wisconsin, pharmacies, and health systems throughout Wisconsin has made a difference to the Wisconsin population with disabilities, ensuring they get help navigating the complex Medicare Part D benefit. Many of these services would not be possible without SHIP funding and certainly not at the levels currently provided. In order to keep pace with inflation and the increasing number of Medicare beneficiaries, funding at the federal level would need to increase from $52.1 million to $66.6 million.

Over the past two grant years, DRW’s Medicare Part D helpline has assisted 1,067 clients. Our call volume increased in grant year 2015 by 62%. Of these contacts with clients, 61% were referred by other agencies. During the 2015 grant year, the Disability Drug Benefit Helpline provided 46 total outreach events to the public, including trainings for professionals. This collaboration with the Aging and Disability Resource Centers, pharmacies, and hospitals throughout Wisconsin has made a difference to Wisconsin residents with disabilities, ensuring they get help navigating the complex Medicare Part D benefit.

Story 1

One woman DRW assisted through the Med D helpline had a substantial and progressive disability. She collected Social Security Disability Insurance and was eligible for Medicare. However, because she was covered through her husband’s employer, she opted out of Part B and never signed up for Part D. Her husband lost his job and the couple divorced. When she called DRW she was completely overwhelmed by the responsibility of two small children, many health needs, very limited funds, and no idea what to do about Medicare or how to access any other benefits for which she might be eligible. A DRW counselor assisted her to obtain insurance through Medicare Part B, sorted through all the Part D prescription drug plans and got her enrolled in one that covered all of her medications.

Story 2

G.K. has been enrolled in a Medicare Part D plan for a number of years and has both Medicare and Medicaid. When she found out that she would have to pay full price for some of her medications and pay a monthly premium, she did not know what to do. She was referred to the helpline for assistance to get a new Part D plan by a local agency. DRW’s helpline counselor updated her drug list in Medicare and discussed plans with a zero monthly premium that will cover all her medications.

Story 3

T.S started on Medicare, lost the coverage he had from his former employer, but did not enroll in a Part D plan. He found out that his medication costs would be more than he could afford. He was referred to the helpline by the pharmacy for help to enroll in a Part D plan. While explaining Part D, DRW’s helpline counselor found out that he had applied for Medicaid and had just been found eligible a few days before. The counselor helped him to enroll in the Low Income Newly Eligible Transition Part D coverage at the pharmacy and enrolled him in a Part D plan to start the following month. He said that he would not have been able to afford his medications if not for the helpline.

The House Appropriations Subcommittee has not yet taken action, but is likely to do so soon.

Disability Rights Wisconsin encourages you to contact your Congressional representative and request them to reach out to their colleagues on the House Appropriations Committee and ask them to reject the Senate’s proposal to eliminate funding and to increase their investment in SHIP, which helps older adults and people with disabilities. This will prevent millions of Americans who need help navigating extremely complex Medicare programs and comparing coverage options from being left stranded.