How Did Medicare Part D Affect Racial and Ethnic Disparities in Drug Coverage?

objectiveTo examine the effect of Medicare Part D on racial/ethnic disparities in having any drug coverage and in sources of payment for drug expenditure.

methodsWe used nationally representative data on whites, African-Americans, and Hispanics aged 55 and older from the 2002-2009 Medical Expenditure Panel Survey to analyze disparities in having any drug coverage and in sources of coverage for individuals aged 65 and older as compared with those for adults aged 55-63 without Medicare.

resultsThere was no disparity in the probability of drug coverage for African-American or Hispanic compared to white Medicare beneficiaries, before or after 2006. There were, however, differences in the sources of coverage. African-Americans and Hispanics over the age of 65 had lower rates of private coverage than whites. This disparity in private coverage was completely offset by minorities' higher rates of drug coverage through Medicaid before 2006 and through Part D since 2006. In contrast, among individuals aged 55-63, there are large and persistent disparities in the probability of having drug coverage throughout the period. DISCUSSION: Pronounced racial/ethnic disparities in drug coverage in the years just before Medicare eligibility are eliminated by access to public coverage at age 65. This was true even before the introduction of Part D.