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25% of low-income older Americans lack health insurance


Despite the fact that most would be eligible for Medicare, many lack any coverage at all

25% of older low-income Americans are uninsured: ©Annap -

25% of older low-income Americans are uninsured: ©Annap -

Researchers from Oregon Health & Science University found that a high number of older Americans lack health insurance.

The study found that about 25% of low-income patients receiving care at community health centers remain uninsured when they turn 65, even though most would become eligible for Medicare coverage. The results were published in the Journal of the American Board of Family Medicine.

Researchers note that its more difficult to manage health conditions without insurance, and that older uninsured patients may face costly hospital stays and avoidable illnesses that require expensive health care services.

The researchers examined electronic health record data for more than 45,000 patients who became eligible for Medicare between 2014 and 2019. The data was from patients seeking care at community health centers, which provide care regardless of ability to pay.

The results showed 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, meaning undocumented immigrants cannot access the government-provided program. Also, patients with low incomes may not be able to afford the Medicare premiums.

Researchers found that patients tend to be diagnosed with new chronic conditions as they become eligible for Medicare. For example, about 86% of the study’s patients had two or more chronic conditions after they turned 65, compared to 77% beforehand. Those who were uninsured prior to enrolling in Medicare were diagnosed with more new chronic conditions than patients who had insurance prior to enrolling. Researchers noted this was most likely because the patients were not aware of the conditions because of a lack of health care access.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health