12 states refused to extend health coverage to the poor after the Affordable Care Act passed in 2010. But there is a way to make people’s lives even better

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Hispanic adults living in the 12 states that refused to extend health coverage to the poor after the Affordable Care Act passed in 2010 would benefit the most from policy proposals to lower the Medicare eligibility age to 60 years, according to a new analysis.

Nearly 43% of Hispanic adults ages 60 to 64 in non-Medicaid expansion states who also earn less than 138% of the federal poverty level — $18,754 for a one-person family — are uninsured, according to researchers from the University of Pittsburgh School of Public Health found in an analysis published in JAMA Network Open Thursday. That’s compared to the 18% of Hispanic adults of similar ages and income levels who are still uninsured despite living in the 39 states that did expand Medicaid coverage.

“Our results suggest the potential for lowering the Medicare threshold at age 60 to reduce existing coverage disparities among adults aged 60 to 64,” the researchers wrote, “particularly among low-income Hispanic adults in states without expansion”.

Among low-income white adults ages 60 to 64 living in non-expanding states, 24.7% were uninsured. (There was no significant difference in insurance levels between black and white adults in the same age and income group in expansion states and non-expansion states, according to the analysis. )

Typically, a senior can access Medicare health insurance once they turn 65, joining the tens of millions of other beneficiaries nationwide who are currently receiving help. to pay for medical visits, hospitalizations and prescriptions as they age. Low-income youth who don’t receive health care through their employer, on the other hand, can access Medicaid — depending on where they live, of course — or qualify for health market subsidies.

However, there are Americans for whom there are virtually no affordable coverage options available, and more often than not they are blacks and Latinos living in states that have not yet expanded Medicaid. They may fall into the group that is too young for Medicare and too poor for subsidies, but not poor and sick enough for their state’s restrictive Medicaid requirements — a problem often described as the “coverage gap.”

The Biden administration sought to close that gap in the failed Build Back Better Act by temporarily allowing people below 100% of the federal poverty level to get the market subsidies from which they have long been excluded. Since Sen. Joe Manchin torpedoed that legislation by saying he couldn’t support it last December, it’s unclear when — or if — it will ever happen.

As the Pittsburgh researchers pointed out in the JAMA analysis, lawmakers could also close the gap with a “Medicare-for-more” policy that lowers the eligibility age, which President Joe Biden has backed. during the election campaign and approved in its fiscal year 2022. budget proposal. Last year, U.S. Representative Pramila Jayapal, a progressive Democrat from Washington state, also led an effort by 130 House lawmakers to lower the eligibility age and expand coverage to at least 23 million. people.

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