Mortality Up With Loss of Low-Income Subsidy for Drugs
THURSDAY, May 15, 2025 -- Loss of the Low-Income Subsidy (LIS) for drugs after Medicaid disenrollment is associated with increased mortality, according to a study published online May 14 in the New England Journal of Medicine.
Eric T. Roberts, Ph.D., from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues identified dual-eligible Medicare-Medicaid beneficiaries, who automatically receive the LIS, and calculated annual rates of Medicaid and LIS loss using 2015 to 2023 Medicare data. Beneficiaries disenrolling from Medicaid in January through June, who kept the LIS through December (six to 11 additional months [early disenrollment]; 969,606 participants) were compared with those disenrolling in July through December (12 to 17 additional months [late disenrollment]; 920,158 participants). The authors sought to examine the relationship between LIS loss and mortality.
The researchers found that those with early and late Medicaid disenrollment averaged 13.6 and 15.3 cumulative months of the LIS in the 17 months after disenrollment, respectively. At 17 months after Medicaid disenrollment, cumulative mortality was higher among those with early versus late disenrollment (78.3 versus 75.3 per 1,000; difference of 3.0 deaths). These mortality differences were amplified among those in the highest quintile of baseline Part D spending (5.6 deaths per 1,000), and for users of medications for cardiovascular disease, chronic lung disease, or HIV.
"Efforts to increase continuous Medicaid and LIS coverage may help protect the health of low-income populations through access to affordable medications," the authors write.
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