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Medicaid Fills In Gaps For Seniors & Older Adults’ Coverage

This April marks the 5th annual Medicaid Awareness Month. Medicaid is an essential pillar in providing coverage for seniors and older Americans. Medicaid remains a critical source of coverage as Americans age, with Medicaid serving as a primary funder for long-term care and filling many of the gaps in Medicare coverage, such as transportation to medical appointments and medical equipment. More than 7.2 million American seniors and 8.5 million adults aged 50 to 64 rely on Medicaid coverage. The benefits of Medicaid for America’s aging population often go unnoticed, but are essential to the health and wellbeing of this population. For seniors and older Americans with low incomes, Medicare premiums are paid by Medicaid, as well as deductibles and health care that requires cost-sharing. Without Medicaid’s supplements to Medicare, millions of seniors would be forced to go without needed care. 

States that expanded their Medicaid programs saw millions of additional seniors and older Americans gain coverage. By rejecting expansion, the 10 non-expansion states are limiting the care older Americans can receive. Despite Medicaid expansion’s proven role in reducing disparities in health care access and improving outcomes, Republicans have spent years undermining the expansion of Medicaid, blocking millions from coverage. Currently, an estimated four million uninsured adults are locked out of coverage in the 10 holdout states

By The Numbers

  • Millions of Seniors & Older Americans Rely On Medicaid Coverage. 7.2 million Americans over 65 are enrolled in Medicaid and more than 8.5 million Americans ages 50 to 64 have health coverage through Medicaid – many thanks to the Affordable Care Act’s Medicaid expansion.
  • Nearly 6 Million Older Adults Live Below The Federal Poverty Level. For millions of seniors and older Americans on fixed incomes, Medicaid is a critical lifeline.
  • Medicaid Funds Nearly Half Of Long-Term Care Nationwide. As seniors age, long-term care services become more essential, serving about 70 percent of seniors who will need some form of long-term care in their lives.
  • More Than 1.9 Million People Would Gain Coverage If Remaining States Expanded Medicaid. Over 1.9 million people would gain Medicaid coverage if the remaining states implemented expansion, roughly 324,000 of the uninsured in the coverage gap are aged 55-64.
  • Medicaid Pays For 62 Percent Of Long-Term Care Residents In Nursing Homes. Medicaid covers nursing home bills for over 60 percent of residents in nursing homes. In 2019, this totaled over $50 billion. The median private nursing home room cost over $100,000 a year in 2021.
  • 12.5 Million Medicare Beneficiaries Also Have Medicaid Coverage. Nearly 10 million of the dual eligible Medicare-Medicaid beneficiaries are “full benefit” Medicaid enrollees who have access to a range of Medicaid benefits, not otherwise covered by Medicare.

Seniors And Older Adults Depend On Medicaid For Affordable, Comprehensive Care. As of 2021, there are 3.6 million older adults going without coverage. Older Americans often have more complex health issues, requiring additional medical attention that is often costly, pushing care out of reach. For seniors on Medicare, Medicaid serves to fill many of the gaps in Medicare coverage, such as transportation to medical appointments and medical equipment. In states that have failed to expand Medicaid coverage, 15,600 older adults died prematurely due to lack of care between 2014 and 2017.

Medicaid Supplements Medicare Coverage For Millions Of Seniors. 12.5 million seniors are Medicare-Medicaid dual beneficiaries. Nearly 10 million are “full benefit” Medicaid enrollees who have access to a range of Medicaid benefits, not otherwise covered by Medicare. Over half of dual enrollees are seniors of color and nearly 4 in 10 dual enrollees suffer from long-term disabilities. 

Medicaid Helps Seniors And Older Americans Stay Retired And Out Of Poverty. Many seniors and older Americans survive off of low incomes or have chronic health conditions that prohibit them from working. Medicaid allows these individuals living on fixed incomes and often have chronic diseases to continue getting the care they need by filling in the gaps in their Medicare coverage without having to worry about choosing between food and housing or their health. Medicaid has long been considered one of the most effective anti-poverty programs in the nation, and its expansion has significantly improved health outcomes for seniors and older adults. In a nation where out-of-pocket health care spending forced more than 10 million Americans into poverty in 2016 alone, Medicaid serves as a lifeline not only for health care, but for economic stability as Americans age. A January 2021 study from Health Affairs found that the ACA helped reduce income inequality across the board, but much more dramatically in Medicaid expansion states.

Low-Income Seniors With Medicare Depend On Medicaid For Long-Term Care. It is estimated that 70 percent of seniors will need long-term care at some point and 62 percent of nursing facility residents utilize Medicaid to receive their care. Medicaid is a critical provider of home and community based care that are essential to keep loved ones at home with their families and neighbors. Without Medicaid, many seniors would not be able to afford these needed services with Medicare alone. 84 percent of individuals in nursing facilities covered by Medicaid in 2019 were dually eligible, with Medicaid covering costs once Medicare benefits have been depleted.