Impact of COVID-19 on racial and ethnic disparities in out-of-pocket health-care spending

Johanna Thunell, Patricia Ferido and Julie Zissimopoulos

Chapter Chapter 5 in Handbook on Inequality and COVID-19, 2025, pp 72-87 from Edward Elgar Publishing

Abstract: This study of community-dwelling older persons enrolled in traditional Medicare quantified racial and ethnic differences in out-of-pocket (OOP) health-care spending two years before and up to two years after an outpatient or inpatient COVID-19 diagnosis occurring in 2020. At time of COVID-19 diagnosis, Black, Hispanic, and American Indian and Alaska Native persons faced higher OOP costs than white and Asian persons. Spending fell significantly in the quarter after diagnosis, but remained slightly elevated for all persons. Higher spending among Black, Hispanic, and American Indian and Alaska Native compared to white persons was consistent across the period. Policies enacted in 2020 - Medicaid’s continuous enrollment and Medicare Advantage’s cost share waiver - may have shielded beneficiaries from high OOP costs associated with COVID-19 and reduced disparities. However, changes in 2021 and 2023 rolling back these policies may exacerbate disparities.

Keywords: Out-of-pocket costs; COVID-19; Disparities; Health-care spending; Racial disparities (search for similar items in EconPapers)
Date: 2025
ISBN: 9781035302758
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