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Expanded Health Coverage Could Save Money Later

After 65, previously uninsured have more annual Medicare spending than continuously insured

TUESDAY, Oct. 6 (HealthDay News) -- Expanding health coverage to adults may result in later savings from reduced Medicare spending on these individuals after they turn 65, especially for the uninsured with cardiovascular disease, diabetes or severe arthritis, according to research published online Oct. 6 in the Annals of Internal Medicine.

J. Michael McWilliams, M.D., of Harvard Medical School in Boston, and colleagues analyzed data from 2,951 adults who were continuously insured before the age of 65, and another 1,616 who were continuously or sometimes uninsured before this age. They assessed annual Medicare spending after age 65 for each participant.

The researchers found that total annual Medicare spending was $1,023 higher for the previously uninsured, which was a significant difference. The previously uninsured had higher annual hospitalization rates for complications related to cardiovascular disease or diabetes (9.1 versus 6.4 percent) and joint replacement (2.5 versus 1.3 percent).

"There are good reasons to believe that insurance coverage in the pre-Medicare years would reduce expenditures during the Medicare years, and health reform advocates will certainly take heart from the authors' conclusions. Unfortunately, because the data and methods used in this study are not capable of supporting causal interpretations, the savings to Medicare are unlikely to be as large as this study suggests," writes the author of an accompanying editorial.

The study was supported by the Commonwealth Fund. Several co-authors reported relevant consulting work and legislative testimony.

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