How Did Medicare Part D Affect Racial and Ethnic Disparities in Drug Coverage?

Abstract

Objective: To examine the effect of Medicare Part D on racial/ethnic disparities in having any drug coverage and in sources of payment for drug expenditure.

Methods: We used nationally representative data on whites, African-Americans, and Hispanics aged 55 and older from the 2002-2009 Medical Expenditure Panel Survey to analyze disparities in having any drug coverage and in sources of coverage for individuals aged 65 and older as compared with those for adults aged 55-63 without Medicare.

Results: There was no disparity in the probability of drug coverage for African-American or Hispanic compared to white Medicare beneficiaries, before or after 2006. There were, however, differences in the sources of coverage. African-Americans and Hispanics over the age of 65 had lower rates of private coverage than whites. This disparity in private coverage was completely offset by minorities' higher rates of drug coverage through Medicaid before 2006 and through Part D since 2006. In contrast, among individuals aged 55-63, there are large and persistent disparities in the probability of having drug coverage throughout the period.

Discussion: Pronounced racial/ethnic disparities in drug coverage in the years just before Medicare eligibility are eliminated by access to public coverage at age 65. This was true even before the introduction of Part D.

Keywords: Medicare Part D; Prescription drug coverage; Racial and ethnic disparities.

Figure 1.

Counts of individuals in the 55-to-63 year olds and 65-and-older groups before and after Medicare Part D (overall total sample of 44,238 individuals). Source: Samples are from the household component files of the 2002–2009 Medical Expenditure Panel Survey. ^a The treatment group consists of Medicare beneficiaries who are aged 65 or older at the beginning of the year and who self-identify themselves as (non-Hispanic) white, (non-Hispanic) African-American, or Hispanic. ^b The comparison group consists of adults without Medicare who are aged 55–63 at the beginning of the year and who self-identify themselves as (non-Hispanic) white, (non-Hispanic) African-American, or Hispanic.

Figure 2.

Prevalence of having drug insurance by year among whites, African-Americans, and Hispanics: 2002–2009.

Figure 3.

Sources of payment for total drug expenditures among Medicare beneficiaries aged 65 or older and among adults aged 55–63 (before and after Part D).