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Medicare eligibility erases many healthcare disparities in US - Healthcare Dive

Dive Brief:

  • Black and Latino people are far more likely to benefit from becoming Medicare eligible than any other demographic group in the U.S., according to a study published Monday in JAMA Internal Medicine.
  • Researchers from Harvard and Yale University and Massachusetts General Hospital concluded that reaching the age of Medicare eligibility does more to eradicate healthcare disparities for Black people than for Latino or White people, although it accomplishes such reductions among all groups.
  • The study also concluded that achieving Medicare eligibility also dramatically reduces the rate of uninsured among Latinos more than any other ethnic group. However, it does not address disparities in mortality rates among the various ethnic groups. Nevertheless, the researchers suggested an expansion of Medicare could be a way to address longstanding disparities in access to healthcare services in the U.S.

Dive Insight:

When it was launched 56 years ago, Medicare became the first single-payer insurance program in the U.S., guaranteeing medical coverage to virtually every American once they turned 65.

Medicare has proven to be a crucial feature of the U.S. safety net, providing healthcare services to tens of millions of Americans while helping to keep them out of poverty.

The JAMA Internal Medicine study has validated the importance of Medicare in terms of leveling the playing field for Americans when it comes to healthcare access — a gap that has been exacerbated by the COVID-19 pandemic. Whereas there are significant gaps in access to healthcare and disparities among ethnic groups, reaching Medicare age wipes much of them out.

According to the study — which examined 2.4 million Americans ages 51 to 79 using data from the Centers for Disease Control and Prevention — insurance coverage for Latinos rose from 77.4% prior to the age of 65 to 91.3% after turning 65. For Black people, it rose from 86.3% to 95.8%. Among White people, insurance coverage was 92% prior to Medicare eligibility and 98.5% after the age of 65.

Disparities in insurance coverage were cut by 53% between Black people and White people, and 51% for Latino people versus White people. The proportion of Black and Latino people who self-reported their health as poor also dropped significantly after they became eligible for Medicare.

The study concluded that while the Affordable Care Act did reduce such disparities among the various ethnic groups prior to attaining Medicare eligibility, it was minimal compared to the changes that occur when turning 65.

"These results highlight the importance of understanding how the effects of public insurance programs differ by locality and race and ethnicity when assessing their potential to advance health equity," the study concluded. "Our findings also suggest that expanding Medicare may be a viable means to reduce racial and ethnic disparities and advance health equity by closing coverage gaps across the U.S."

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Medicare eligibility erases many healthcare disparities in US - Healthcare Dive
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