In the Health Affairs blog today, Stacy Sanders, Medicare Rights’ federal policy director, writes with Maura Caslyn of the Center for American Progress about risks that the American Health Care Act (AHCA) poses to people who rely on the Medicare Savings Programs (MSPs). MSPs are Medicaid programs that help low-income older adults and people with disabilities afford their Medicare premiums and cost sharing.

There are four different MSPs—the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Disabled and Working Individual (QDWI) programs—each with its own eligibility criteria. Federal law sets baseline income and asset limits for each MSP but grants states flexibility to expand access to these vital programs. The federal limits are exceedingly low. In most states, full Medicare premium and cost-sharing assistance is only available for people with annual incomes at or below 100% of the federal poverty level, which is about $12,000, and with personal savings totaling a little more than $7,000.

The article explains that under current law, the federal government pays a set percentage of all costs incurred by a state’s Medicaid program—including the MSPs—to all eligible individuals. Under the AHCA the federal share paid toward MSPs would be expected to continue—but that doesn’t mean these programs are safe.

This is because “as the federal government starts to pay a smaller share of Medicaid funding under Republican plans to cap or otherwise limit federal support for the program, states will face heightened budgetary pressures. States that have opted to build a more effective and efficient safety net by offering more generous MSPs may eliminate those expansions altogether.”

Furthermore, they warn that “as the AHCA is taken up in the Senate, MSPs may be targeted more directly, and possibly, more severely.”

Read the blog post on Health Affairs.