LEGISLATIVE FISCAL ESTIMATE
[First Reprint]
ASSEMBLY, No. 2
STATE OF NEW JERSEY
220th LEGISLATURE
DATED: JUNE 19, 2023
SUMMARY
Synopsis: Increases the income eligibility threshold and eliminates asset test for
Medicare Savings Programs; appropriates funds.
Type of Impact: Annual State expenditure and revenue increases.
Agencies Affected: Department of Human Services.
Office of Legislative Services Estimate
Fiscal Impact Annual
State Cost Increase $459.7 million
State Revenue Increase $235.7 million
 The Office of Legislative Services (OLS) estimates that this bill will increase annual State
costs by $459.7 million due to increasing the income eligibility threshold and eliminating the
asset test for the Qualified Medicare Beneficiary Program, the Specified Low-Income
Medicare Beneficiary Program, and the Qualifying Individual Program. Generally, these
programs are referred to as Medicare Savings Programs, which are federal programs
administered by the Division of Medical Assistance and Health Services in the Department of
Human Services and which provide people with limited income and resources assistance in
paying their Medicare Part A and B premiums, copayments, coinsurances, and deductibles.
 As the programs identified in the bill are Medicaid-administered programs, the State will also
experience an increase in revenue in the form of federal Medicaid reimbursements totaling
$235.7 million, for a net State cost of $224.0 million.
BILL DESCRIPTION
This bill increases the income eligibility threshold and eliminates the asset test for the Qualified
Medicare Beneficiary Program, the Specified Low-Income Medicare Beneficiary Program, and
the Qualifying Individual Program. Under the bill, the Department of Human Services is directed
to implement a State Medicaid benefit, that maximizes federal available funding, to provide State
Office of Legislative Services Legislative Budget and Finance Office
State House Annex Phone (609) 847-3105
P.O. Box 068 Fax (609) 777-2442
Trenton, New Jersey 08625 www.njleg.state.nj.us
 FE to A2 [1R]
2
residents enrolled in the Medicare program, whose incomes are equal to or less than 200 percent
of the federal poverty level, and without regard to resident’s assets, with assistance in the payment
of Medicare Part A and B premiums, copayments, coinsurances, and deductibles.
The bill authorizes the Department of Human Services to establish alternative income
eligibility standards under the bill in order to comply with federal law and regulations and to
maximize federal funding available under the Specified Low-Income Medicare Beneficiary and
Qualifying Individual programs, provided that the alternative income eligibility standards are no
higher than 230 percent of the federal poverty level. To the extent that federal law and regulation
do not permit the provision of assistance under these two programs, the bill directs the department
to provide such assistance via a separate subprogram using State funds only.
FISCAL ANALYSIS
EXECUTIVE BRANCH
None received.
OFFICE OF LEGISLATIVE SERVICES
The OLS estimates that this bill will increase annual State costs by $459.7 million due to
increasing the income eligibility threshold to 200 percent of the federal poverty level and
eliminating the asset test for the Qualified Medicare Beneficiary Program, the Specified Low-
Income Medicare Beneficiary Program, and the Qualifying Individual Program. Generally, these
programs are referred to as Medicare Savings Programs, which are federal programs administered
by the Division of Medical Assistance and Health Services in the Department of Human Services
and which provide people with limited income and resources assistance in paying their Medicare
Part A and B premiums, copayments, coinsurances, and deductibles.
Currently, New Jersey implements the federal income threshold– between 100 percent and 135
percent of the federal poverty level - and asset cap - $9,090 for individuals and $13,630 for married
couples – to determine eligibility for these Medicare Savings Programs. Under these eligibility
requirements, according to the Kaiser Family Foundation, in 2019, 223,365 Medicare beneficiaries
in the State, or 13 percent of the total Medicare population, were enrolled in a Medicare Savings
Program. Based upon the experiences in other states that have utilized the federal authority under
the Social Security Act to increase the income threshold and eliminate the asset cap for these
programs, this estimate assumes that enrollment in Medicare Savings Programs will grow by
171,819 enrollees to 23 percent of the Medicare population; thereby, reflecting a 76.9 percent
increase in enrollment under the Qualified Medicare Beneficiary, Specified Low-Income Medicare
Beneficiary, and Qualifying Individual programs.
The OLS notes that while the bill allows for the income threshold for the Specified Low-
Income Medicare Beneficiary and Qualifying Individual Programs to be as high as 230 percent of
the federal poverty level if required to comply with federal law and regulation, this estimate
assumes that all programs will operate at an income threshold of 200 percent of the federal poverty
level. Moreover, this estimate assumes that federal Medicaid reimbursements will be approved
for all benefits provided under the bill. Absent these assumptions, State costs under the bill would
increase.
The OLS also notes that according to the FY 2024 Governor’s Budget the projected cost to
support the Qualified Medicare Beneficiary Program, the Specified Low-Income Medicare
Beneficiary Program, and the Qualifying Individual Program in FY 2024 is $597.6 million, $291.3
 FE to A2 [1R]
3
million in State resources and $306.4 million in federal resources in the form of Medicaid
reimbursements.
Section: Human Services
Analyst: Sarah Schmidt
Lead Research Analyst
Approved: Thomas Koenig
Legislative Budget and Finance Officer
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the
failure of the Executive Branch to respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).


Statutes affected:
Introduced: 30:4D-3