Loss of Medicare Part D subsidy linked to higher mortality among low-income older adults

While it may seem intuitive that people would die without life-saving medications, researchers have connected losing a federally funded prescription drug assistance program and an increase in mortality. The program, called the Medicare Part D Low-Income Subsidy (LIS), helps 14.2 million low-income Medicare beneficiaries, many of whom are older Americans, afford their medications. Nationally, 12.5 million people who are eligible for and enrolled in both Medicare and Medicaid (“dual eligibles”) automatically qualify for the LIS, which is worth about $6,200/year.

The study, published in the New England Journal of Medicine by researchers at the Perelman School of Medicine and Harvard T.H. Chan School of Public Health, reveals that losing Medicaid coverage—and with it, the LIS—was associated with significant increases in mortality among low-income Medicare beneficiaries.

Roberts and collaborators focused on one of the sickest groups on public insurance—the dual eligible beneficiaries who qualify for both Medicare and Medicaid. Nearly 1 million of this group lose Medicaid each year.

The team found that when older adults lost access to low-cost drugs after losing Medicaid, their death rate jumped by 4%, leading to nearly 3,000 more deaths during an 11-month period. Deaths rose even more among individuals with higher drug spending and those taking medications for chronic conditions such as heart disease, HIV, and chronic lung conditions.

“When Medicare beneficiaries lose Medicaid, which happens to more than 900,000 people each year, they also risk losing the LIS and therefore, being able to afford the medicines they need,” says lead author Eric T. Roberts, associate professor of general internal medicine at the Perelman School of Medicine and a Leonard Davis Institute of Health Economics senior fellow. 

This story is by Karl Stark. Read more at Penn LDI.