Older adults most concerned about health care costs heading into election

Key takeaways:

• Five of the top six concerns were related to the costs of health care and health insurance.
• Older adults are most concerned about the costs of home care and assisted living.

Older adults are most concerned about issues relating to the costs of health care and health insurance heading into the 2024 United States election, a research letter published in JAMA revealed.

Results from a survey of older adults identified cost-related issues most often but also included concerns about access to care, quality of care and medical misinformation.

“Although policymakers have taken steps in recent years to reduce health care costs for older adults, particularly related to prescription drugs in Medicare, our survey suggests older voters have a strong interest in more action on this issue,” John Z. Ayanian, MD, MPP, director of the University of Michigan’s Institute for Healthcare Policy and Innovation, told Healio. “Candidates for president and Congress should focus on communicating their plans for controlling the costs of health care.”

Adults aged 50 years and older cast over half the ballots in the 2020 U.S. election, according to the researchers.

“Issues related to health and health care are often key factors for voters, particularly for older adults who typically have greater health needs than younger adults,” they wrote. “To understand which health-related concerns are most salient before the 2024 election, we surveyed a nationally representative cohort of adults [aged] 50 years or older.”

In the survey, respondents (n = 2,576) were asked if they were somewhat concerned, very concerned or not concerned about 26 health-related policy issues for older adults in their community.

The researchers then calculated the weighted percentages for respondents who reported being very concerned about each issue, “accounting for the complex survey design.”

Overall, the top six most concerning issues to respondents were:

• the cost of home care, assisted living or nursing home care (56.3%);
• the cost of medical care (56.2%);
• the cost of prescription medicine (54.3%);
• financial scams and frauds (52.8%);
• the cost of health insurance and Medicare (52.1%); and
• the cost of dental care (44.6%).

Ayanian and colleagues pointed out that smaller proportions of older adults, ranging from 10.6% to 38.1%, reported being very concerned about the other 20 issues.

The proportion of older adults who worried about health costs significantly varied between those aged 50 to 64 years vs. those aged 64 to 101 years (59.6% vs. 53.4%), men vs. women (59.3% vs. 54.1%), liberals vs. moderates (68.2% vs. 56.4%), moderates vs. conservatives (56.4% vs. 51.4%) and those in metropolitan areas vs. those in nonmetropolitan areas (55.9% vs. 61.7%)

The researchers highlighted some study limitations, which included a lack of data on personal health issues and non-health issues “that may influence older voters’ preferences.”

“As a primary care provider myself, I know that patients of all ages, and especially older adults with greater health care needs, are very concerned about their out-of-pocket costs and ability to afford their health care,” Ayanian told Healio. “PCPs can be proactive in advising their patients about the potential costs of their care and help them to choose more cost-effective ways to meet their health care needs.”

He added that as new policies are implemented to control health care costs, “it will be important to assess whether older adults believe they are benefiting from these policies.”

References

• As election approaches, national poll shows which health topics concern older adults most. Available at: https://www.eurekalert.org/news-releases/1054381. Published Aug. 14, 2024. Accessed Aug. 14, 2024.
• Ayanian J, et al. JAMA. 2024;doi:10.1001/jama.2024.14353.