The health effects of Medicare for the near-elderly uninsured.

TitleThe health effects of Medicare for the near-elderly uninsured.
Publication TypeJournal Article
Year of Publication2009
AuthorsPolsky, D, Doshi, JA, Escarce, JJ, Manning, W, Paddock, SM, Cen, L, Rogowski, J
JournalHealth Serv Res
Date Published2009 Jun
ISSN Number1475-6773
Call Numbernewpubs20090908_Polsky_etal.pdf
KeywordsAged, Attitude to Health, Female, Follow-Up Studies, Health Services Accessibility, Health Services Research, Health Status, Health Surveys, Humans, Insurance Coverage, Logistic Models, Male, Medically Uninsured, Medicare, Mortality, Multivariate Analysis, Program Evaluation, Retirement, Socioeconomic factors, Statistics, Nonparametric, United States

OBJECTIVE: To determine whether Medicare enrollment at age 65 has an effect on the health trajectory of the near-elderly uninsured.

DATA SOURCES: Eight biennial waves (1992-2006) of the Health and Retirement Study, a nationally representative panel survey of noninstitutionalized 51-61 year olds and their spouses.

STUDY DESIGN: We use a quasi-experimental approach to compare the health effects of insurance for the near-elderly uninsured with previously insured contemporaneous controls. The primary outcome measure is overall self-reported health status combined with mortality (i.e., excellent to very good, good, fair to poor, dead).

RESULTS: The change in the trajectory of overall health status for the previously uninsured that can be attributed to Medicare is small and not statistically significant. For every 100 persons in the previously uninsured group, joining Medicare is associated with 0.6 fewer in excellent or very good health (95 percent CI: -4.8, 3.3), 0.3 more in good health (95 percent CI: -3.8, 4.1), 2.5 fewer in fair or poor health (95 percent CI: -7.4, 2.3), and 2.8 more dead (-4.0, 10.0) by age 73. The health trajectory patterns from physician objective health measures are similarly small and not statistically significant.

CONCLUSIONS: Medicare coverage at age 65 for the previously uninsured is not linked to improvements in overall health status.

User Guide Notes

Endnote Keywords

Medicare/health status/Health Insurance/Health Benefits

Endnote ID


Alternate JournalHealth Serv Res
Citation Key7304
PubMed ID19674430
PubMed Central IDPMC2699915
Grant ListR01 AG024451 / AG / NIA NIH HHS / United States
R01 AG024451-01 / AG / NIA NIH HHS / United States