Open AccessChanges in Health for the Uninsured After Reaching Age‐eligibility for Medicare
Author(s) -
Baker David W.,
Feinglass Joseph,
DurazoArvizu Ramon,
Witt Whitney P.,
Sudano Joseph J.,
Thompson Jason A.
Publication year - 2006
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2006.00576.x
Subject(s) - medicine , health and retirement study , health insurance , confidence interval , relative risk , demography , gerontology , cohort study , cohort , health care , sociology , economics , economic growth , pathology
BACKGROUND: Uninsured adults in late middle age are more likely to have a health decline than individuals with private insurance. OBJECTIVE: To determine how health and the risk of future adverse health outcomes changes after the uninsured gain Medicare. DESIGN: Prospective cohort study. PARTICIPANTS: Participants ( N =3,419) in the Health and Retirement Study who transitioned from private insurance or being uninsured to having Medicare coverage at the 1996, 1998, 2000, or 2002 interview. MEASUREMENTS: We analyzed risk‐adjusted changes in self‐reported overall health and physical functioning during the transition period to Medicare ( t −2 to t 0 ) and the following 2 years ( t 0 to t 2 ). RESULTS: Between the interview before age 65 ( t −2 ) and the first interview after reaching age 65 ( t 0 ), previously uninsured individuals were more likely than those who had private insurance to have a major decline in overall health (adjusted relative risk [ARR] 1.46; 95% confidence interval [CI] 1.03 to 2.04) and to develop a new physical difficulty affecting mobility (ARR 1.24; 95% CI 0.96 to 1.56) or agility (ARR 1.33; 95% CI 1.12 to 1.54). Rates of improvement were similar between the 2 groups. During the next 2 years ( t 0 to t 2 ), adjusted rates of declines in overall health and physical functioning were similar for individuals who were uninsured and those who had private insurance before gaining Medicare. CONCLUSIONS: Gaining Medicare does not lead to immediate health benefits for individuals who were uninsured before age 65. However, after 2 or more years of continuous coverage, the uninsured no longer have a higher risk of adverse health outcomes.