Access to Care

Health improves when previously uninsured adults become eligible for Medicare

When previously uninsured adults with diabetes and cardiovascular disease become eligible for Medicare, their health improves, a recent study finds. Researchers tracked 5,006 (69.2 percent) adults who had health insurance and 2,227 (30.8 percent) who had no insurance, or had it sporadically, from 1992 to 2004 to determine the effect access to care had on health.

Before the uninsured group was eligible for Medicare, their summary health scores were much worse than those who had insurance. After age 65, the uninsured group's scores significantly improved, especially for those who had cardiovascular disease or diabetes. This improvement might be explained by their having better access to ambulatory care and medications for their conditions.

Previously uninsured adults with cardiovascular disease or diabetes also saw improvements in their general health, mobility, and agility once they were covered. Further, when compared with previously insured adults, those who were previously uninsured suffered less frequent heart attacks, had fewer cases of severe angina, and had fewer hospitalizations for heart failure once they had Medicare coverage.

This study provides evidence of how Medicare coverage positively affects health outcomes for previously uninsured adults, especially those with cardiovascular disease or diabetes, the authors conclude. Health improvements such as these have led to the idea of providing early access to Medicare being introduced in the U.S. Congress and recommended by the American College of Physicians as a way to improve health outcomes in the United States. (For a related article by the same author, go to the November 2007 Research Activities.) This study was funded in part by the Agency for Healthcare Research and Quality (T32 HS000020).

See "Health of previously uninsured adults after acquiring Medicare coverage," by J. Michael McWilliams, M.D., Ellen Meara, Ph.D., Alan M. Zaslavsky, Ph.D., and John Z. Ayanian, M.D., M.P.P., in the December 26, 2007, Journal of the American Medical Association 298(24), pp. 2886-2894.

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