• Posted September 18, 2023

1 in 4 Older, Low-Income Americans Are Uninsured

As people age, health issues tend to mount, but roughly a quarter of low-income adults over 65 have no medical insurance.

That's the age when most Americans become eligible for Medicare, the federal health insurance for seniors. But many of the uninsured seniors are Hispanic Americans who aren't eligible for that coverage, or lower income people who may not be able to afford Medicare premiums.

“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,” said study first author Nathalie Huguet, an associate professor of family medicine at Oregon Health & Sciences University.

“It's more challenging to manage health conditions in the United States without insurance," she said in a university news release. "This can lead to costly hospital stays and avoidable illnesses that require expensive health care services.”

For the new study, researchers examined electronic health record data for more than 45,000 patients who became eligible for Medicare between 2014 and 2019.

These records covered visits at community health centers, which largely serve people with limited finances. They provide care regardless of a patient's ability to pay.

The study found that it was more common for Hispanic Americans to lose insurance coverage at 65.

Medicare requires participants to be U.S. citizens or permanent legal residents. Undocumented immigrants are unable to receive this health coverage.

In addition, patients with low incomes may be unable to afford Medicare premiums.

The study also revealed that patients are often diagnosed with new chronic health conditions like diabetes or high blood pressure after they become eligible for Medicare.

In all, about 86% of patients studied had two or more chronic health conditions after they turned 65 -- compared to 77% of patients younger than 65.

Patients who had been uninsured and then obtained Medicare were diagnosed with more new chronic conditions than patients who had insurance before enrolling in Medicare, the authors said.

“It's likely these patients unknowingly had chronic conditions for beforehand,” Huguet said. “Medicare enables older Americans to receive the essential health care that they need. However, having access to health care earlier in life can also prevent conditions from developing or getting worse as we age.”

The authors said they hope their research will encourage policymakers to improve access to care for aging Americans, especially preventive care. They also hope community health centers will offer more senior-focused care.

The findings were published online Sept. 13 in the Journal of the American Board of Family Medicine. The U.S. National Institute of Aging provided support for the research.

More information

The U.S. National Institute on Aging has more on healthy aging.

SOURCE: Oregon Health & Science University, news release, Sept. 14, 2023