Income Limit Jeopardizes Health Care for Low-Income Seniors in Vermont

JEFFERSONVILLE, Vt. — When Jamie and Linda Draper turned 65, they were hit with thousands of dollars in health care costs due to a state policy that reduces subsidies for older Vermonters living in near poverty. The couple, surviving on an annual income of about $28,000, found themselves ineligible for the full benefits of Vermont’s Medicaid program, unlike most low-income residents, once they turned 65.

Chief of the Vermont Office of the Health Care Advocate, Mike Fisher, explained that many people underestimate the expenses associated with Medicare for low-income individuals, leading to financial strain on those like the Drapers. Despite living a Vermont-centric life filled with various manual labor jobs, the couple found themselves facing an unexpected financial setback, denied benefits that would cover their Medicare supplemental insurance by a mere $18.

The issue at hand has lawmakers like Essex Junction Rep. Lori Houghton pushing for legislative solutions to raise income limits for the Medicare Savings Program. Houghton’s efforts stem from the recognition that transitioning from Medicaid to Medicare results in increased health care expenses for low-income individuals, particularly impacting older women with historically lower earning power. This disparity persists even in Vermont, as older women have a median annual income of $19,566, significantly less than men of the same age.

For the Drapers, as well as others like Middlebury resident Pam Spatafora, the financial limitations have tangible impacts on their health care. Spatafora, who sacrificed the last few years of her career to care for her husband with Alzheimer’s, now finds herself unable to afford crucial medications not covered by her Medicare plan. Meanwhile, Dr. Mark Pasanen of UVM Medical Center expressed concern over the future health outcomes and increased costs that may result from older Vermonters losing Medicaid benefits as they transition to Medicare.

Proposed legislation to increase eligibility for the Medicare Savings Program is gaining traction, but the Scott administration reveals that funding the eligibility increase is not included in the governor’s budget proposal. However, other states like Maine, Massachusetts, and Connecticut have implemented similar eligibility changes in recent years, prompting calls for long-overdue reforms in Vermont.

The current policy’s impact on vulnerable Vermonters has prompted a crucial question posed by Spatafora to elected officials: Can they live on $1,255 a month? As the debate and analysis continue, the urgency of welfare support for low-income older Vermonters remains at the forefront.

For any questions, comments, or tips, please feel free to reach out and contact the reporter, Peter Hirschfeld.