News: Medicare beneficiaries with near low income face disproportionate financial burden, study says

Medicare beneficiaries with near low income are “particularly likely” to experience affordability challenges related to healthcare costs, according to a new JAMA Network Open study.

The newly released study sought to examine how healthcare affordability problems vary by income level and subsidy eligibility among Medicare beneficiaries. It examined 24,398 Medicare beneficiaries using data from the 2018-2022 Medical Expenditure Panel Survey.

According to the researchers, household income was categorized into four groups: low income (<100% of the federal poverty level [FPL]), near low income (100%-150% of FPL), middle income (150%-400% of FPL), and high income (>400% of FPL).

Moreover, the researchers established three types of healthcare affordability problems:

• Financial burden, i.e., spending +20% of annual post-subsistence income on out-of-pocket costs
• Financial barriers to care, e.g., delaying or foregoing care due to cost
• Medical debt

While the authors noted that “out-of-pocket spending increased with increasing income,” their main conclusion underscored the “disproportionate” financial strain that beneficiaries with “near low income” (i.e., 100%-150% of FPL) faced.

“After adjusting for age, sex, and health status, 54.0% of beneficiaries with near low income reported experiencing at least 1 affordability problem, compared with 43.0% in the low-income group, 45.2% in the middle-income group, and 25.5% in the high-income group. These patterns remained consistent across all affordability measures,” they concluded.

Editor’s note: To read the JAMA study, click here.