title: The Care Span: Lower Hispanic participation in Medicare Part D may reflect program barriers.
abstract: Despite the successes of Medicare's Part D prescription drug program, an estimated 12.5 percent of Americans ages sixty-five and older do not have prescription drug coverage. It is possible that some who remain without coverage do so for rational economic reasons. However, barriers to insurance uptake, such as the program's complexity, may exist for certain elderly people. Racial and ethnic minorities may be particularly susceptible to these barriers. To investigate the role that race and ethnicity may play in Medicare Part D participation, we analyzed data from the 2011 National Health and Aging Trends Study. We found that Hispanics were 35 percent less likely than non-Hispanic whites to have coverage, after individual predictors of prescription drug demand were controlled for. There was no statistically significant difference in Part D coverage between non-Hispanic blacks and non-Hispanic whites. Results of a stratified analysis suggest that the difference between Hispanics and non-Hispanic whites in Part D coverage may be driven by ethnic disparities among those eligible for the low-income Part D subsidy but not automatically enrolled in it. Further research is needed to identify both the exact mechanisms underlying the observed differential uptake in the rapidly growing elderly Hispanic population and potential policy-based solutions.
authors.forename: Brian E
authors.initials: BE
authors.lastname: McGarry
authors.forename: Robert L
authors.initials: RL
authors.lastname: Strawderman
authors.forename: Yue
authors.initials: Y
authors.lastname: Li
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005380:Financing, Government / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008297:Male; D054524:Medicare Part D / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data*; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data*
keywords: Disparities; Insurance; Medicare; Minority Health