By Jennifer M. McGivney
A new study examines the consequences older adults face when they lose Medicaid coverage and must rely solely on Medicare.
How are financial and physical health affected when an older adult hits the Medicare Cliff—losing Medicaid coverage and relying on Medicare alone? Without Medicaid, is Medicare enough?
This situation affects about 280,000 people each year, and a recent study examined the consequences they face when they lose Medicaid coverage. The study, Long-Term Changes in Health Care Use and Outcomes Among Groups Maintaining Versus Losing Medicaid Upon Medicare Enrollment, was a collaboration between researchers at the LeadingAge LTSS Center @UMass Boston and the National Council on Aging.
The study found that when people permanently lose their Medicaid coverage, they experience worse health outcomes, higher mortality, and higher out-of-pocket costs.
“Our analysis shows how consequential Medicaid is for the health of individuals, the costs to the healthcare system, and the financial well-being of older adults, even when factoring in Medicare benefits,” says Maryssa Pallis, the lead author of the paper and a PhD student in gerontology at UMass Boston.
When older adults lose Medicaid coverage, they lose the program’s cost-sharing protections, which help cover Medicare premiums, copayments, and deductibles. The loss of this financial support has cascading effects: Older adults may seek less preventive care, their costs may rise, and their health may worsen.
This research is relevant now, as federal policies tighten Medicaid eligibility, says Marc Cohen, an author of the paper and co-director of the LeadingAge LTSS Center @UMass Boston.
“The government is putting in place policies right now that will lead to millions of Americans losing their Medicaid coverage,” says Cohen. “We can see from empirical data that this is very likely to lead to a host of negative health and welfare consequences.”
Even amid tightening federal restrictions, Pallis notes two reasons to be hopeful about the study’s findings. First, the results clearly show that addressing the Medicare cliff can reduce mortality and improve the health and well-being of older adults. Second, states have the power to enact changes that would allow more people to maintain their Medicaid coverage and avoid the Medicare Cliff.
“States have real opportunities here to address the Medicare Cliff,” Pallis says. “They can strengthen outreach and enrollment in Medicare Savings Programs or adopt Medicaid income disregards that effectively raise eligibility from 100% to 138% of the federal poverty level. These state-level actions could help older adults maintain access to affordable preventive care, reduce financial strain, and improve health outcomes even in the absence of federal eligibility reform.”
Read more at UMass Boston’s Gerontology Institute Blog.