Quarter of Low-income Older Americans have no Medical Insurance

Quarter of Low-income Older Americans have no Medical Insurance

Health problems tend to increase as people age, but about a quarter of all low-income adults aged 65 and over have no health insurance at all.

This is the age at which most Americans become eligible to enroll in Medicare, which is the federal health insurance program for seniors. However, many uninsured seniors are Latinos, who are not eligible for Medicare, or people with lower incomes who cannot afford Medicare premiums.

The idea that older adults may not have health insurance is especially worrying, as the incidence of disease and associated complications increases with age, Huguet, the study’s first author, a family medicine associate professor at Oregon Health & sciences University, said.

“In the United States, without insurance, it is more difficult to manage health conditions,” Huguet said in the university news release, “which can result in costly hospital stays and preventable illnesses that require costly healthcare services.”

For this study, researchers analyzed electronic health record (EHR) data from over 45,000 patients enrolled in Medicare from 2014 to 2019. These records included visits to community health centers. Community health centers provide care to people with limited financial means, regardless of a patient’s ability to pay for care.

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According to the study, losing insurance coverage at 65 was more common among Hispanic Americans.

In order to be eligible for Medicare, participants must either be a US citizen or permanent legal resident, and undocumented immigrants are not eligible. Additionally, low-income patients may not be able to pay for Medicare premiums. The study also found that patients are more likely to be diagnosed with a new chronic health condition after becoming eligible for Medicare, with 86 percent of patients aged 65 and over having two or more such conditions, compared with 77 percent of those aged 65 and under.

According to Huguet and his colleagues, “Patients who were uninsured and then got Medicare were more likely to have new chronic conditions compared to those who had insurance prior to Medicare.”

“Medicare allows older Americans to get the essential healthcare they need, but it also allows them to have access to care earlier in life, thus reducing the risk of conditions developing or worsening as they age.”

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According to the authors, their hope is that their research will motivate policy makers to enhance access to care, particularly preventive care, for the growing number of aging Americans. They also expect community health centers to focus more on senior care.

The findings were published online recently in the Journal of the American Board of Family Medicine. The U.S. National Institute of Aging provided support for the research.

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