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1 1 (October 23, 2023)

handle is hein.crs/govenfz0001 and id is 1 raw text is: Updated October 23, 2023 State Health Insurance Assistance Program (SHIP) Background The State Health Insurance Assistance Program (SHIP) provides funding to states for outreach, counseling, and information assistance to Medicare beneficiaries and their families and caregivers on Medicare and other health insurance issues. The national program is authorized under Section 4360 of the Omnibus Budget Reconciliation Act of 1990, as amended (OBRA '90; P.L. 101-508; 42 U.S.C. 1395b-4). The Consolidated Appropriations Act, 2014 (P.L. 113-76) transferred SHIP administration from the Centers for Medicare & Medicaid Services (CMS) to the Administration for Community Living (ACL). This transfer, effective in 2016, reflected the existing formal and informal collaborations between the state SHIP projects and the networks served by ACL. There are SHIP projects in all 50 states, as well as the District of Columbia and three U.S. territories (Guam, Puerto Rico, and the U.S. Virgin Islands). Of the 54 SHIP grant programs, about two-thirds are administered by State Units on Aging established under the Older Americans Act. The remaining one-third are located in their state insurance commissioner offices. SHIP services are often delivered in partnership with local Area Agencies on Aging and other community-based organizations. Grant Activities SHIP grants provide funding for states to plan and operate various information, counseling, and assistance activities. Medicare beneficiaries have received assistance through one-on-one counseling in person, by telephone, on the Internet, or through email from paid and volunteer SHIP counselors. State SHIP projects also conduct public outreach and education activities to inform beneficiaries about coverage and enrollment options. The SHIP grants support a community-based network of state and local programs that provide personalized assistance to Medicare beneficiaries and their families on questions related to Medicare, supplemental insurance policies (Medigap), Medicare Advantage plans, Medicare Savings Programs, Medicaid eligibility and coverage issues, long-term care insurance, and other health insurance issues. Since the passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (P.L. 108- 173), a major focus of SHIP-funded programs has been to help beneficiaries obtain Medicare prescription drug coverage, Medicare Part D, and enroll in the Medicare prescription drug low-income subsidy program and in Medicare Savings Programs. According to ACL, over 12,500 SHIP team members, half of whom were volunteers, in over 2,200 local organizations connected with almost 1.8 million individuals through one- on-one client contacts and an additional 2.6 million individuals through public events explaining the Medicare program and its benefits in the grant year beginning April 1, 2021, and ending March 31, 2022. Funding The majority of SHIP funding is provided through discretionary budget authority in the annual Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) Appropriations Act. Discretionary funding is also supplemented by mandatory funding for outreach and assistance to low-income Medicare beneficiaries (see Table 1). Table I. State Health Insurance Assistance Program (SHIP) Funding, by Type (FY2009 to FY2023) Discretionary Year Funding FY2009 $47,400,000 Mandatory Funding $7,500,000 FY2010 $46,960,000 $15,000,000 FY20 I I $52,000,000 a FY20 12 FY20 13 FY20 14 $52,115,000 $46,040,000 $52,115,000 $7,I 15,000b $7,500,000 FY20I5 $52,115,000 $7,500,000 FY2016 $52,115,000 $13,000,000 FY2017 $47,115,000 $12,103,000c FY2018 $49,115,000 $13,000,000 FY2019 $49,115,000 $13,000,000 FY2020 $52,115,000 $13,000,000 FY2021 $52,115,000 $15,000,000 FY2022 $53,115,000 $15,000,000 FY2023 $55,242,000 $15,000,000 Source: HHS, ACL and CMS budget justifications (FY2009 through FY2023); P.L. 115-245, P.L. 110-275, as amended (see 42 U.S.C. 1 395b-3 note; and personal communication with ACL. Notes: Amounts are not adjusted for inflation. a. The Patient Protection and Affordable Care Act (P.L. I 11-148, as amended) appropriated $15 million for FY2010-FY2012. b. $7.5 million appropriated; amount reflects 5.1% reduction due to mandatory spending sequester. c. $13 million appropriated; amount reflects 6.9% reduction due to mandatory spending sequester. Discretionary Funding OBRA '90 (P.L. 101-508) authorized the appropriation of $10 million in equal parts from the Medicare trust funds (i.e., the Federal Hospital Insurance Trust Fund and the

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