A new study conducted by Oregon Health & Science University reveals gaps in health insurance coverage for older Americans, who typically have more health issues than younger Americans.
The study, published in the Journal of the American Board of Family Medicine, found that approximately one-fourth of low-income patients obtaining care at community health centers remain uninsured at age 65, the age at which the majority of Americans become eligible for Medicare federal health insurance.
The OHSU School of Medicine associate professor of family medicine Nathalie Huguet, Ph.D., said, “It’s particularly concerning to think of older adults not having health insurance, given that the prevalence of disease and related complications increase with age.” Without insurance, it is more difficult to manage health conditions in the United States. This can result in costly hospital stays and preventable diseases requiring costly health care services.
Huguet and colleagues examined the electronic health record data of more than 45,000 Medicare-eligible patients who became eligible between 2014 and 2019. The records were for patient interactions at community health centers, which provide care regardless of a patient’s capacity to pay and primarily serve individuals with limited financial resources.
Their in-depth analysis of the data revealed that Hispanic Americans were more likely to lose insurance coverage at age 65. Medicare requires its participants to be either U.S. citizens or permanent legal residents, making the program inaccessible to undocumented senior immigrants. In addition, Medicare premiums may be out of reach for patients with modest incomes.
After patients become eligible for Medicare, they are more likely to be diagnosed with chronic conditions such as diabetes or hypertension. Approximately 86% of the patients in the study had two or more chronic health conditions after turning 65, compared to 77% before this age. Patients who were uninsured prior to enrolling in Medicare were diagnosed with a greater number of new chronic conditions than patients who had insurance prior to enrolling in Medicare.
“It’s likely that these patients had chronic conditions without their knowledge,” Huguet said. Medicare enables senior Americans to obtain the necessary health care services. Having access to health care earlier in life, however, can prevent conditions from developing or worsening as we age.”
Huguet and her colleagues hope that their findings will persuade policymakers to better support aging Americans by enhancing their access to health care in general and preventive care in particular. In addition, they hope it will motivate community health centers to incorporate more geriatric-focused care into their operations.
