Project Grant RF1AG103341

The National Institute on Aging awarded the University of Pennsylvania $2,414,176 on September 1, 2026, under the Aging Research program (CFDA 93.866) to examine Medicaid coverage transitions and instability among older adults and evaluate policy interventions that mitigate disruption-related impacts on care and health outcomes.

The project will analyze three distinct coverage disruption scenarios using national surveys and linked Centers for Medicare & Medicaid Services data. Aim 1 examines the transition to Medicare primary insurance at age 65, investigating changes in Medicaid eligibility, losses of cost-sharing support, effects on Medicare Advantage enrollment, outpatient care utilization, medication use, and resulting health outcomes. Aim 2 investigates Medicaid churn among dual-eligible beneficiaries following the restart of redeterminations in 2023, analyzing the frequency of cycles on and off Medicaid and the sequential impacts of losing both Medicaid and prescription drug subsidies. Aim 3 evaluates practices designed to reduce abrupt coverage losses. The project recognizes that coverage disruptions increase out-of-pocket costs for routine care and medications and remain poorly understood despite their frequency among low-income older adults.

Work is performed in Philadelphia, Pennsylvania. The award period runs through August 31, 2030. The assistance type is a Project Grant, which supports investigator-initiated research directed toward understanding the aging process and diseases affecting older populations.