Medicare Part D and Disparities in Chronic Disease among the U.S. Elderly Population

Pinka Chatterji
Associate Professor of Economics, University at Albany.

Background: Health insurance may be a key factor underlying disparities in chronic disease among the U.S. elderly population. Notably, a study that used data from 1999 to 2006 found that racial/ethnic disparities in control of blood pressure and diabetes become smaller after age 65, suggesting that Medicare reduces disparities in chronic disease. Medicare introduced optional prescription drug coverage in 2006 (Part D). The introduction of Part D may have made Medicare an even more important factor in remediating disparities given the important role of prescription drugs in controlling chronic disease. Prior work suggests that there are racial/ethnic differences in medication adherence for chronic diseases, and Part D has increased medication usage overall among the elderly population. To our knowledge, however, no studies have investigated the potentially strong effects of Part D on older adults’ awareness and control of chronic disease, or the effects of Part D on racial/ethnic and education-related disparities in chronic disease. The project will address two specific aims:

Aim 1: Test whether the introduction of Medicare Part D affected disparities in awareness and control of hypertension, diabetes, and hyperlipidemia using national data sets that include biomarkers.
Aim 2: Test whether Part D affected disparities in prescription drug use and out-of-pocket spending on drugs among elderly individuals with chronic diseases.