For 'Near Poor' Seniors, Medicaid 'Cliff' Could Keep Health Care Out Of Reach

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MONDAY, April 10, 2023 (HealthDay News) -- The so-called "Medicaid cliff" is a constant threat to millions of Americans whose incomes are below the poverty line.

While poorer seniors have Medicaid to cover health care costs, slightly higher-income seniors face higher Medicare costs out of pocket.

The result: They are much less likely to see a doctor or write a prescription. And a new study blames the "gap" on racial and ethnic disparities, as black and Hispanic adults whose annual incomes exceed the federal poverty line are more likely to face aid spending barriers.

Older whites are more likely to save for medical expenses, researchers say.

"Chronic disease risks among older people of color are largely overlooked due to financial barriers to treatment, and our research shows that Medicaid deficits contribute to these barriers," said Eric Roberts, assistant professor of health policy and management. University of Pittsburgh School of Public Health.

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"Fixing it so that people on Medicare don't face higher half-payments above the poverty line could reduce health disparities among our nation's older adults," Roberts said in a university press release.

He proposed an alternative.

"One option is to turn the 'cliff' into a 'smooth hill' that ends Medicaid assistance for seniors with incomes just above the federal poverty line," Roberts said.

Medicare is the federal health insurance program for people age 65 and older and with disabilities. It has co-pays and co-pays with a large share of costs.

Medicare beneficiaries who earn no more than $14,600 a year will receive Supplemental Medicaid coverage to help offset these costs. They also receive subsidies to reduce out-of-pocket costs of prescription drugs.

The study found that while other federal programs are phasing out aid, Medicaid recipients with incomes above the poverty line will be cut.

For the study, researchers examined data from 8,144 Medicare recipients, comparing health care use across both lines of Medicaid eligibility. They compared outcomes for white recipients, black recipients, and Hispanic recipients.

The study found that living below the poverty line, and therefore ineligible for Medicaid, reduced annual outpatient visits by 21 percent.

Blacks and Hispanics on Medicare wrote 15 percent fewer prescriptions, the study found little change for whites.

"And other research confirms it — we've found that white consumers are more likely to save to cover medical expenses," Roberts said. “The income that the federal government uses to determine Medicaid eligibility may give the impression that blacks and Hispanics have the same ability to pay for care as their white counterparts. The reality is they have different criteria and we see the impact of skipping doctor visits and essential medications."

Blacks and Hispanics are more likely than their white counterparts to develop chronic diseases such as diabetes and heart disease, he said.

The authors call for expanding Medicaid eligibility for older people and gradually reducing assistance above the poverty line. Such measures could complement inflation-reducing provisions designed to make drugs more affordable for older people, he said.

The study results were published April 10 in JAMA Internal Medicine .

The National Council on Aging has more information about financial security and seniors.

Source: University of Pittsburgh press release, April 10, 2023.

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