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1 1 (February 4, 2019)

handle is hein.crs/govyal0001 and id is 1 raw text is: Congresina Reeac Seric 0 Updated February 4, 2019 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 (OBRA '90; P.L. 101-508; 42 U.S.C. 1395b-4). The Consolidated Appropriations Act of 2014 (P.L. 113-76) transferred SHIP administration from the Centers for Medicare and Medicaid Services (CMS) to the Administration for Community Living (ACL). This transfer reflected the existing formal and informal collaborations between the state SHIP projects and the networks that ACL serves. An interim final rule, effective February 4, 2016, reflected the transfer from CMS to ACL (81 Federal Register 5917, February 4, 2016). The interim final rule was adopted without change on June 3, 2016 (81 Federal Register 35643, June 3, 2016). There are SHIP projects in all 50 states, as well as the District of Columbia, Guam, Puerto Rico, and the 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. Grant Activities SHIP grants provide funding for states to plan and operate various information, counseling, and assistance activities. Medicare beneficiaries receive 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, in 2016 over 14,000 SHIP counselors, mostly volunteers, in over 1,300 community-based organizations connected with individuals through more than 102,000 public and media events and 3.3 million one-on- one client contacts. Funding The majority of SHIP funding is provided through discretionary budget authority provided annually in the Departments of Labor, Health and Human Services, and Education, and Related Agencies (LHHS) Appropriations act. However, 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 FY2019) Discretionary Mandatory Year Funding Funding FY2009 $47,400,000 $7,500,000 FY20I 0 $46,960,000 $15,000,000 FY20 II $52,000,000 a FY2012 $52,115,000 a FY2013 $46,040,000 $7,1 15,000b FY2014 $52,115,000 $7,500,000 FY201 5 $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 Source: HHS, ACL and CMS budget justifications (FY2009 through FY2017); H.Rept. 115-952, p. 588 (FY2018-FY2019); P.L. 115-245, P.L. 110-275, as amended (see 42 U.S.C. 1395b-3 note); and personal communication with ACL. Notes: Amounts are not adjusted for inflation. a. The Patient Protection and Affordable Care Act (P.L. II 1-148, as amended) appropriated $15 million for FY2010-FY2012. b. $7.5 million appropriated; amount reflects 5.10% 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 Federal Supplementary Medical Insurance Trust Fund) for each of FY1991 to FY1993. Congress and the President subsequently extended SHIP authorizations of appropriations to FY1996 under P.L. 103-432. While the authorization of appropriations expired in FY1996, https:I/crsreports.conc -- _-_

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