Health Care Utilization Rises, Worries About Medical Bills Fall As Adults Enroll In Medicare

Health Care Utilization Rises, Worries About Medical Bills Fall As Adults Enroll In Medicare

The survey examines the differences between low-income adults aged 64 and 66.

Health care utilization increases and worries about medical bills decrease when low-income adults without health insurance can enroll in Medicare.

The findings were part of a survey that looked at the health care outcomes of more than 1.66 million 64-year-olds without health insurance and 1.49 million 66-year-olds who qualified for Medicare at 65, the age at which most Americans become eligible for it. cover.

The findings could influence federal lawmakers’ debates about expanding Medicare eligibility by lowering the age at which people can apply and improving health equity across the board. the country.

Currently, Medicare provides health insurance to over 50 million seniors in the United States. More than 40% of American adults under age 65 are uninsured or underinsured, said co-author Rishi K. Wadhera, MD, MPP, MPhil, in a press release.

“The majority of Americans do not become eligible for health insurance coverage until age 65, and our results suggest that this transition is associated with significant improvements in access to health care, affordability and reduced financial strain for low-income adults, and to a lesser extent, for high-income adults,” said Wadhera, assistant professor of medicine at Beth Israel Deaconess Medical Center in Boston. As policymakers debate whether to expand Medicare, our study provides evidence that lowering the Medicare eligibility age can advance health equity in the United States.”

The researchers looked at three factors and found substantial changes between age groups for low-income patients at or below 300% of the federal poverty level, and above that level.

Researchers looked at outcomes of access, including recent doctor visits, medical care delayed due to cost, or needed medical care that patients did not receive due to cost. Among low-income people age 64, 14.7% delayed care and 15.5% avoided care because of cost, while among people age 66, 5.9% delayed care and 6.2% avoided care due to cost, according to the study.

They also considered financial constraints such as problems paying medical bills, the inability to pay those bills, or worrying about covering costs if someone fell ill or had an accident. At age 64, 66.5% of low-income adults were worried about medical bills and 33.9% had difficulty paying medical bills, but these percentages dropped to 51.1% and 20.6%, respectively , for people aged 66.

The results were more modest and less consistent for adults whose income was above 300% of the federal poverty level. Medicare eligibility did not affect prescription drug outcome percentages of low- or high-income adults, such as skipping doses, taking less, or delaying filling doses to save money, or not getting prescription drugs because of cost, according to the study.

The authors noted that there are growing income health inequalities in the United States and rapid changes in the health care landscape over the past decade, including the passage of the affordable care, expanding Medicaid, and increasing “underinsurance” or inadequate insurance for working-age adults. In light of these factors, “our study provides new and timely insights into the impact of Medicare eligibility and enrollment on a contemporary population of low-income adults.”

“Medicare eligibility and health care access, affordability, and financial strain for low- and high-income adults in the United States: A regression discontinuity analysis”, was published on October 4, 2022 in PLoS medicine.

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