title: Transitioning From Medicaid Disability Coverage to Long-Term Medicare Coverage: The Case of People Living With HIV/AIDS in California.
abstract: Medicaid can serve as a bridge to Medicare coverage for the long-term disabled with sufficient covered work experience. We perform multinomial logistic regression on 2007-2010 Medicare and Medicaid claims data to examine transitions to Medicare for people living with HIV/AIDS (PLWHA) in California who had Medicaid coverage in 2007. We find only 16% had obtained Medicare coverage by 2010. African-Americans, women, individuals with schizophrenia diagnoses, alcohol or substance abuse disorders, and any physical comorbidity were significantly less likely than others to obtain Medicare (p < 0.001). This study contributes new information on the impact of eligibility requirements for Medicare long-term disability insurance for PLWHA. About one-third of PLWHA under age 65 are covered by Medicaid. Many PLWHA get stuck in Medicaid because their disability prevents them from obtaining the additional employment experience needed to qualify for Medicare.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA).
authors.forename: Warren S
authors.initials: WS
authors.lastname: Comulada
authors.affiliation: Department of Public Policy, UCLA Luskin School of Public Affairs.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Desmond
authors.affiliation: Department of Public Policy, UCLA Luskin School of Public Affairs.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Gildner
authors.affiliation: Department of Public Policy, UCLA Luskin School of Public Affairs.
authors.forename: Arleen A
authors.initials: AA
authors.lastname: Leibowitz
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use; D002140:California; D006233:Persons with Disabilities; D004608:Eligibility Determination / Q000191:economics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data*; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data*; D007353:Insurance, Long-Term Care / Q000191:economics / Q000706:statistics & numerical data; D016015:Logistic Models; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data; D008875:Middle Aged; D014481:United States; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents