Division of General Internal Medicine, Mount Sinai Medical Center, New York, New York 10029, USA.
J Aging Soc Policy. 2009 Oct-Dec;21(4):338-51. doi: 10.1080/08959420903166993.
Medicaid is an important source of supplemental health care coverage for low-income seniors, yet little is known about the effect of state policy on Medicaid enrollment by eligible elderly. Data from a nationally representative survey were used to examine Medicaid enrollment by elderly, low-income Medicare beneficiaries living in states that liberalize or restrict Medicaid eligibility criteria using the 1986 Omnibus Budget Reconciliation Act or provision 209(b) of the 1972 Social Security Act Amendment, respectively. Controlling for demographics and health status, residence in states applying these laws was significantly, though modestly, associated with Medicaid enrollment. Additionally, 73% of eligible elderly Medicare beneficiaries were not enrolled in Medicaid, and most have serious chronic health problems. These findings suggest that a significant number of eligible elderly are not enrolled in Medicaid and that liberalizing or tightening Medicaid eligibility criteria can have an impact on Medicaid enrollment by low-income elderly patients.
医疗补助是低收入老年人补充医疗保健的重要来源，但对于州政策对符合条件的老年人参加医疗补助的影响知之甚少。本研究使用全国代表性调查数据，根据 1986 年综合预算协调法案或 1972 年《社会保障法修正案》第 209(b)条，分别考察了放宽或限制医疗补助资格标准的州中，符合条件的老年低收入医疗保险受益人的医疗补助参保情况。在控制人口统计学和健康状况后，居住在实施这些法律的州与医疗补助参保显著相关，尽管关联程度适中。此外，73%的符合条件的老年医疗保险受益人未参加医疗补助，而且大多数人患有严重的慢性健康问题。这些发现表明，相当数量的符合条件的老年人没有参加医疗补助，放宽或收紧医疗补助资格标准可能会对低收入老年患者的医疗补助参保情况产生影响。
