Medicare improves racial healthcare inequities
Medicare is associated with reductions in racial and ethnic disparities in insurance coverage, access to care and self-reported health across the U.S., according to a new study published in JAMA.
Researchers from Yale and Harvard examined Medicare data from 2008 through 2018, with more than 2.4 million respondents in the study sample. They looked at recipients before and after they became eligible, finding Americans were much more likely to have health insurance immediately after turning 65 compared to just before 65 years of age.
The study comes at a time when policymakers are still considering pushing for a Medicare-for-all healthcare option.
“Understanding the association of Medicare with access to care and health outcomes nationally and by race and ethnicity informs the ongoing debate over Medicare expansion,” wrote first author Jacob Wallace, PhD, of the Yale School of Public Health, et al.
Access to care improved for all racial and ethnic groups under Medicare, with the biggest improvements for Black and Hispanic respondents compared to white respondents.
Insurance coverage for Black respondents increased 9.5% once they became eligible for Medicare, while coverage rose 13.9% for Hispanic respondents. There was a 53% reduction in the disparity between White and Black adults and a 51% reduction in the disparity between White and Hispanic adults, the researchers found.
In addition, the share of people who self-reported poor health declined upon receiving Medicare. The share of people in poor self-reported health decreased by 3.8% for Hispanic respondents and 2.6% for Black respondents, but only 0.2% for White respondents. This meant the disparity in self-reported poor health fell 55% between White and Black respondents and 40% between White and Hispanic respondents.
“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.,” Wallace et al. concluded.