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Could More Older Adults Qualify for Medicaid?

By Lisa Watts


LTSS Center researchers tested alternative eligibility criteria that could increase the number of older adults who qualify for Medicaid.


The Medicaid program uses income standards and stringent limits on financial assets to determine an individual’s eligibility for benefits. But how many additional people could qualify for Medicaid benefits if those eligibility rules were changed?

Marc Cohen and Jane Tavares, researchers at the LeadingAge LTSS Center @UMass Boston, had a hunch that Medicaid eligibility criteria exclude many older adults whose health and financial security are vulnerable. The researchers used data from the Health and Retirement Study to determine whether using alternative eligibility criteria could increase the number of older adults who could qualify for Medicaid benefits.

Those alternatives included:

  • Using the Supplemental Poverty Measure, which factors in expenses like taxes and healthcare costs and counts some noncash benefits as income.
  • Using the Elder Index, developed at the University of Massachusetts Boston, which offers a more accurate accounting of basic cost-of-living expenses—including housing, healthcare, and food—for older adults in each county of the U.S.
  • Requiring that beneficiary income be less than 138% of the Federal Poverty Level, which aligns with the Medicaid threshold for adults who are younger than 65 and not living with disabilities.
  • Allowing beneficiaries to own assets of $7,970 for single adults and $11,960 for couples.
  • Placing no limits on household assets.

While policymakers fear adding more recipients would bankrupt Medicaid, Tavares says the study found that “we’re not talking about a massive number of additional people. And they look like people who could benefit tremendously from the coverage.”

Research findings were published in The Journal of Aging & Social PolicyRead more about the study at the Gerontology Institute Blog.