Medicare & Medicaid


Cuts to Medicare or Medicaid have a direct and disproportionate impact on diverse elders. Among those over age 55, 46 percent of Latinos are covered by Medicare, 43 percent of Asians, and 52 percent of African Americans. For all races, those not solely receiving Medicare coverage receive health insurance through a variety of other providers: military heath care, Medicaid and private insurance, Medicare and private insurance, or Medicaid and Medicare. Preservation of Medicare and Medicaid is critically important to the health and economic well-being of diverse elders.


As with Social Security, not all senior populations have equal access to important protections under Medicaid. For example, same-sex couples in most states are excluded from “spousal impoverishment” protections. Medicaid, the single largest payer of long-term care in the U.S., requires an individual to spend down all of his/her assets in order to become eligible for long-term care coverage. For married heterosexual couples, however, Medicaid has exemptions to avoid forcing a healthy spouse to give up all resources, and live in poverty, in order to qualify a spouse for long-term care. Unfortunately, these spousal impoverishment protections do not apply to same-sex domestic partners. While the Obama Administration recently notified states that they are allowed to correct these inequities, further action should be taken to require states to extend spousal impoverishment protections to same-sex couples.

This excerpt is taken from Securing Our Future: Advancing Economic Security for Diverse Elders, by the Insight Center for Community Economic Development. Read the full report >>