A proposed settlement of a nationwide class-action lawsuit should make it easier for tens of thousands of disabled and chronically ill people to qualify for Medicare coverage. It is clearly the humane thing to do for desperately sick people with little hope of recovery.

This change could add substantial costs to a program that needs to reduce projected spending to remain sustainable in the long run. The solution to Medicare’s cost problem is not to deny needed services but to make the delivery of care more efficient and less expensive, and to ensure better management of care for the chronically ill.

There may even be some savings under the settlement. If patients are able to get medical services and therapy in their homes, some may be able to avoid more expensive care in hospitals and nursing homes.

As Robert Pear reported in The Times on Tuesday, under the agreement, the Obama administration will end a longstanding practice of requiring many beneficiaries to show they are likely to improve before Medicare will pay for skilled nursing or therapy services.