Medicaid 'cliff' prevents many seniors from seeking healthcare

April 12, 2023 : The so-called “Medicaid cliff” is a yearly threat for millions of American seniors whose earnings put them above the poverty line.

While poor seniors often have Medicaid to help cover their healthcare costs, seniors who make just a little bit more have to spend the higher out-of-pocket costs of Medicare themselves.

The result: They’re much less possible to visit the doctor or fill prescription medicines. And a new investigation blame this “cliff” for increasing racial and ethnic differences, noting that Black and Hispanic adults whose annual earnings is just above the federal poverty bar are more likely to encounter cost-related barriers to care.

Researchers stated that white seniors are more likely to have savings for out-of-pocket medical expenses.

“Chronic disease dangers among older adults of color often go unaddressed due to cost-related obstacles to care, and our research indicates that this Medicaid cliff contributes to these barriers,” stated researcher Eric Roberts, Assistant professor of health policy & Management at the University of Pittsburgh School of Public Health.

“Correcting this so that people on Medicare don’t face substantially more elevated copays above the poverty threshold could lessen healthcare injustices among our nation’s seniors,” Roberts declared in a university news release.

He offered a possible choice.

“One possibility is to turn the ‘cliff’ into a ‘gentle hill,’ by tapering Medicaid help for seniors with earnings slightly above the federal poverty line,” Roberts stated.

Medicare is a federal healthcare insurance program for people who are 65 and older, as well as people with disabilities. It has increased cost-sharing, containing deductibles and copays.

Medicare beneficiaries who drive up to about $14,600 a year offer supplemental Medicaid insurance to help offset these expenses. They also get a subsidy to lesser out-of-pocket prescription drug prices.

While other federal programs taper off assistance on a sliding scale, Medicaid cuts off legatee with incomes that are even slightly past the poverty line, according to the study.

Researchers examined data on 8,144 Medicare beneficiaries for the study, comparing healthcare service on either side of the Medicaid eligibility line. They also corresponded outcomes for White beneficiaries, Black recipients, and Hispanic legatee.

The analysis tied being just above the poverty line and ineligible for Medicaid to a 21% reduction in annual outpatient visits.

Black and Hispanic residents on Medicare also filled 15% more occasional prescriptions, while the study found barely any change for White individuals.

“We found — and other research aids — that White beneficiaries are more usually to have savings to pull upon to cover medical costs,” Roberts stated. “The income that the federal government sees to decide Medicaid eligibility may make it seem that Black and Hispanic beneficiaries have the same ability as their White counterparts to pay for care. But the reality is that they don’t have the same resources — and we’re seeing the result of that in their forgoing doctor’s visits and required medications.”

The study told Black and Hispanic beneficiaries are more likely than their White peers to have chronic illnesses such as diabetes and heart disease that can be managed with medicines.

The authors dubbed for expanding Medicaid eligibility for older adults and tapering service above the poverty threshold. They told such moves could complement the Inflation Reduction Act provisions created to make drug costs more affordable for seniors.

Analysis findings were posted Monday in JAMA Internal Medicine.