Study: Medicare access narrows racial gaps in coverage, healthcare costs

Access to Medicaid may help address racial disparities in insurance coverage, access and self-reported outcomes, according to a new study.

The research, published in JAMA Internal Medicine, tracked more than 2.4 million Americans and found that immediately after turning 65, and thus becoming eligible for Medicare, coverage for Black respondents increased from 86.3% to 95.8%.

Among Hispanic respondents, coverage increased from 77.4% to 91.3%.

By comparison, white respondents had the highest level of coverage before gaining Medicare eligibility, at 92%. But coverage rates did increase for whites, too, reaching 98.5% after age 65, according to the study.

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In addition, the study found that gaining Medicare coverage narrowed gaps in access to a usual care provider, cost of care and flu vaccine rates between white and Hispanic participants. Similar results were not found between white and Black patients, however, according to the study.

"The results highlight an underappreciated aspect of Medicare: it is associated with sharp reductions in racial and ethnic disparities at age 65 years," the authors wrote.

"However, racial and ethnic disparities were not eliminated by Medicare, supporting the view that disparities are shaped not only by policy decisions but also other social determinants of health, such as structural racism, that persist among elderly individuals," they said.

Expanding Medicare eligibility has been a hot-button political topic of late, with plans ranging from lowering the eligibility age to 50 or 55 to a Medicare for All single-payer system.

The researchers said that their findings should be a consideration as any plans move forward, as they suggest Medicare expansion is a viable path to addressing health disparities.

"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 US," they wrote.