Medicaid expansion and changes for low-SES pre-retirees

1/26/2018 feature story

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Helen Levy

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Improving the Health of Low-SES Americans Approaching Retirement Under the Affordable Care Act

Low-SES Americans approaching retirement face a crisis of poor health and markedly increasing mortality. Between 2001 and 2014, the life expectancy gap for low- and high-SES adults near retirement grew, but the drivers of this disparity are poorly understood. The Affordable Care Act (ACA) should improve access to care through insurance expansions and care delivery innovations and help this group manage chronic conditions and improve their health. However, it is not clear how low-SES aging adults are specifically benefitting from ACA policies, which groups should be principally targeted for new care delivery programs encouraged under the ACA, and what factors are associated with successful health improvement and decreased costs for at-risk aging Americans. Using HRS data, this project will gauge changes in coverage, access, utilization, health, and financial stress for low-SES 55-64-year-olds before and after the ACA Medicaid expansion; classify sub-groups of low-SES 55-64-year-olds at highest risk of poor health; characterize heterogeneity of changes in access, utilization, health and costs in identified high-risk sub-groups; and identify facilitators of and barriers to improvements in health outcomes and health care utilization among high-risk low-SES aging adults in an ACA care delivery program.

Renuka Tipirneni, Kenneth M. Langa, Helen Levy, John W. Creswell, Kara Zivin, Donovan T. Maust, Kevin John Dombkowski

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