The Kaiser Family Foundation on Racial Inequities within Medicare

A new report from the Kaiser Family Foundation finds racial and health inequities among beneficiaries

As the nation continues to weather the COVID-19 pandemic, one issue has been brought into the spotlight: the disproportionate impact the virus has on communities of color. Members of racial and ethnic minority groups are placed at a higher risk of contracting COVID-19 while also facing higher mortality rates. Experts agree that COVID-19 inequities are representative of much bigger issues facing our country: systemic health and social inequality at large. To investigate this, researchers at the Kaiser Family Foundation (KFF) analyzed the characteristics, experiences, and outcomes of the Medicare beneficiary population by race and ethnicity.

The researchers utilized recent primary and secondary data analyses by KFF, as well as a variety of other sources including the Centers for Medicare & Medicaid Services (CMS) Office of Minority Health’s Mapping Medicare Disparities Tool. They also documented disparities in income and wealth among Americans receiving Medicare. Their findings showed stark differences in health outcomes between white beneficiaries and beneficiaries of color.

1. Among Medicare beneficiaries, people of color are more likely to report being in relatively poor health, suffering from a chronic illness, or having more hospital visits.

KFF researchers found that over a third of Black and Hispanic beneficiaries report being in fair or poor health (34 and 37 percent, respectively), whereas only 21% of white beneficiaries say the same. In addition, over a third of Black and Hispanic beneficiaries reported limitations in daily living activities, which the researchers defined as actions like bathing and eating. Those limitations can have long-term implications for people of color, including an increased risk of hospitalization, admission to long-term facilities, cognitive impairment, or even mortality.

These conditions of “poor health” can also lead to a higher risk of disease, which was clearly seen among the Medicare beneficiaries in the study. Several chronic illnesses—even ones that are generally common—are far more prevalent in people of color.

The figure below illustrates the rates of certain chronic conditions among Medicare beneficiaries:

Image Source

The image shows that Black and Hispanic Medicare beneficiaries suffer from higher rates of several chronic diseases. Hypertension, for example, is one of the most common ailments across all Medicare beneficiaries, but Black and Hispanic beneficiaries have much higher rates than white beneficiaries. The same applies to diabetes, which almost half of all Black and Hispanic Medicare beneficiaries live with.

However, this trend does not apply to all chronic illnesses. In fact, the report indicated that certain conditions are actually more prevalent among white beneficiaries than others. As displayed in the figure, depression is reported by a smaller share of Black beneficiaries (21%) than white beneficiaries (26%). The researchers also found that cancer has a 19% prevalence rate among white beneficiaries, compared to 15% for both Black and Hispanic beneficiaries.

2. More Black and Hispanic beneficiaries reported difficulty with getting needed care than white beneficiaries.

While relatively few Medicare beneficiaries reported difficulties with access to care overall, more Black and Hispanic beneficiaries (10 and 11 percent, respectively) than white beneficiaries (6%) reported trouble getting needed care.

This trouble includes delays in getting a doctor’s appointment and challenges while trying to find a new specialist. Black and Hispanic beneficiaries also reported far more difficulties with paying their medical bills than white beneficiaries did, indicating that policy conversations regarding “access to health care” should include cost-related barriers as well. Of those struggling to pay their bills, Black Medicare beneficiaries also represented the largest share of people reporting debt to collection agencies due to medical bills.

All this is to say that the socioeconomic disadvantages associated with race contribute to greater health inequities in old age—and studying the latest data sets has led KFF researchers to conclude that these inequities will only be exacerbated further by the COVID-19 pandemic.

What does this mean for the future?

The KFF researchers found that among adults ages 65 and older, the mortality and hospitalization rates from COVID-19 were far higher for Hispanic, American Indian/Alaska Native, and Black people than for white people. Cases are also higher among these minority populations—nearly 1.7 times higher for all groups—than they are for white populations.

The data shows that action must be taken to protect vulnerable racial and ethnic minority groups from COVID-19 and other illnesses. If even those with Medicare coverage are suffering from these health inequities, policymakers must work to ensure the health and well-being of marginalized populations everywhere.

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