# Impact of Medicaid Continuous Coverage for Older Adults with Alzheimer's Disease and Related Dementias

> **NIH NIH P01** · BROWN UNIVERSITY · 2024 · $408,064

## Abstract

PROJECT SUMMARY
Among the 5+ million Medicare beneficiaries living with Alzheimer's disease and related dementias (ADRD),
one-quarter are dually enrolled in Medicaid. Medicaid is a needs-based insurance program that covers long-
term services and supports and Medicare out-of-pocket costs. Almost one third of low-income older adults who
join Medicaid lose Medicaid coverage within a year. Even though older adults may remain eligible for Medicaid,
failing to complete complicated eligibility redetermination paperwork can lead to loss of benefits. However,
during the COVID-19 pandemic, a temporary federal policy guaranteed continuous Medicaid coverage by
suspending disenrollments due to Medicaid redeterminations. The end of this protection in 2023 put 1+ million
Medicare beneficiaries living with ADRD at risk for losing Medicaid coverage. Even though Medicaid is the
nation's primary source of financial assistance with health care and long-term care costs, there is limited
evidence on how losing Medicaid coverage affects people living with ADRD and their health outcomes. This
gap in knowledge is concerning given the projected increase in the number of people living with ADRD, a large
proportion of whom will qualify for Medicaid. The long-term goal of our research is to improve access to care
and services for low-income older adults living with dementia. The objective of this project is to identify
predictors of retaining Medicaid coverage for people living with ADRD and to learn how federal Medicaid policy
changes affected the health of people living with ADRD. Our central hypotheses are that 1) losing Medicaid
coverage will be more common for people living with ADRD and will vary by residential setting; and 2) federal
policy changes that temporarily guaranteed Medicaid continuous coverage improved health outcomes for
people living with ADRD. We will test these hypotheses through three aims that employ mixed methods and
strong quasi-experimental research techniques: 1) Describe how Medicaid retention differs for older adults with
an ADRD diagnosis across settings; 2) Estimate the effect of retaining Medicaid coverage among older adults
with ADRD on health outcomes; 3) Estimate the effect of ending Medicaid continuous coverage policies among
older adults with ADRD on health outcomes. The findings from this research will inform policymakers and
community organizations' decision-making around the ways to increase Medicaid participation and ensure
optimal health outcomes for people living ADRD. Further, this research aligns with a top research priority
identified by the National Academy of Medicine to improve quality of life for people with ADRD by reducing
financial stressors and enabling access to key services. Specifically, the findings from this work will provide
novel evidence on the effects of Medicaid participation and its role in supporting access to long-term care
services and medical care among people with ADRD.

## Key facts

- **NIH application ID:** 10934970
- **Project number:** 2P01AG027296-16
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Kali St. Marie Thomas
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $408,064
- **Award type:** 2
- **Project period:** 2007-09-15 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10934970

## Citation

> US National Institutes of Health, RePORTER application 10934970, Impact of Medicaid Continuous Coverage for Older Adults with Alzheimer's Disease and Related Dementias (2P01AG027296-16). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10934970. Licensed CC0.

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