@article {11547,
	title = {Medicaid Coverage {\textquoteright}Cliff{\textquoteright} Increases Expenses And Decreases Care For Near-Poor Medicare Beneficiaries.},
	journal = {Health Affairs },
	volume = {40},
	year = {2021},
	pages = {552-561},
	abstract = {<p>Cost sharing in traditional Medicare can consume a substantial portion of the income of beneficiaries who do not have supplemental insurance from Medicaid, an employer, or a Medigap plan. Near-poor Medicare beneficiaries (with incomes more than 100~percent but less than 200~percent of the federal poverty level) are ineligible for Medicaid but frequently lack alternative supplemental coverage, resulting in a supplemental coverage "cliff" of 25.8~percentage points just above the eligibility threshold for Medicaid (100~percent of poverty). We estimated that beneficiaries affected by this supplemental coverage cliff incurred an additional $2,288 in out-of-pocket spending over the course of two years, used 55~percent fewer outpatient evaluation and management services per year, and filled fewer prescriptions. Lower prescription drug use was partly driven by low take-up of Part D subsidies, which Medicare beneficiaries automatically receive if they have Medicaid. Expanding eligibility for Medicaid supplemental coverage and increasing take-up of Part D subsidies would lessen cost-related barriers to health care among near-poor Medicare beneficiaries.</p>},
	keywords = {Medicaid, Medicare},
	issn = {1544-5208},
	doi = {10.1377/hlthaff.2020.02272},
	author = {Roberts, Eric T and Glynn, Alexandra and Cornelio, Noelle and Donohue, Julie M and Gellad, Walid F and McWilliams, J Michael and Lindsay M Sabik}
}
