Coverage Disparities Increase for Low-Income Hispanic Adults in States Without Medicaid Expansion

A larger share of Hispanic individuals were uninsured compared to White individuals among low-income adults aged 60-64 years, and the disparity increased in states without expanded Medicaid. Researchers published their findings in JAMA Network Open.

“One reform under consideration by Congress, termed Medicare-for-more, would lower the age threshold for Medicare to age 60 years from 65 years,” authors said. “If enacted, this policy would extend near-universal insurance to a larger share of the US population. We assessed potential for expanding Medicare to reduce existing coverage disparities among Black and Hispanic adults vs White adults aged 60 to 64 years.”

The cross-sectional study involved data from the 2019 American Community Survey, which authors used to determine the demographic, residential, and insurance information of participants.

Demographic data showed 52.1% of all US adults aged 60-64 years were female (95% CI, 52%-52.4%). Additionally, “12.3% (95% CI, 12.1%-12.5%) were Black, 11.6% (95% CI, 11.4%-11.8%) were Hispanic, and 76.1% (95% CI, 75.9%-76.4%) were White.”

Hispanic adults (15% [95% CI, 11.1%-19.2%]) comprised a larger share of uninsured individuals across all incomes and states in 2019 compared to Black adults (6.9% [95% CI, 5.8%-8%]) and White adults (7% [95% CI, 6%-8.1%]).

More than 10% of Black adults were uninsured in 17 states, and more than 10% of Hispanic adults were uninsured in 38 states, findings showed.

Coverage disparities between Hispanic and White individuals with incomes less than 138% of the federal poverty line grew larger in states without expanded Medicaid. In expansion states, researchers found a coverage disparity of 6.6 percentage points (95% CI, 2.7-10.5 percentage points; P <.001), and this disparity grew by 11.4 percentage points in nonexpansion states (95% CI, 3.2-19.5 percentage points; P = .007).

There were no significant coverage disparities between Black adults and White adults in states with or without expanded Medicaid, authors said.

Researchers noted these findings are based on the most current data available, which predates the COVID-19 pandemic.

“Emerging evidence suggests coverage disparities during the pandemic widened in nonexpansion states. Thus, our results may conservatively reflect the current extent of coverage disparities among older adults,” authors concluded.

Reference:
Patterson A, Robinson TJ, Roberts ET. Racial and ethnic disparities in insurance coverage among US adults aged 60 to 64 years. JAMA Netw Open. 2022;5(4):e229406. doi:10.1001/jamanetworkopen.2022.9406