There’s a quiet safety net beneath millions of low-income older Americans, and it’s fraying.
A new study published in the New England Journal of Medicine draws a sharp line between loss of prescription drug assistance and increased mortality. Specifically, it examines what happens when low-income Medicare beneficiaries lose the Medicare Part D Low-Income Subsidy (LIS), a program that helps over 14 million Americans afford medications that keep them alive.
The results are sobering. Among nearly 1 million individuals studied, those who lost LIS experienced a 4% higher mortality rate, with some vulnerable populations, like people living with HIV, seeing mortality jump by 22%.
The Medicaid–LIS Connection
The LIS is closely tied to Medicaid. Roughly 12.5 million individuals are “dual eligibles,” those enrolled in both Medicare and Medicaid, receive the subsidy automatically. But when someone loses Medicaid, something that happens to over 900,000 people each year, they often lose LIS too.
And that’s not always because they’ve become ineligible. The study found that over half of those who lost Medicaid were re-enrolled within a year. That suggests something else is at play: system-level churn, administrative red tape, or state-level redeterminations gone wrong.
Widespread Coverage Losses
Medicaid redeterminations following the COVID-19 public health emergency are causing widespread coverage losses, particularly among older adults. These losses are cascading into LIS disenrollment, leaving seniors without critical medications for heart conditions, HIV, diabetes, depression, and more.
The LIS provides an estimated $6,200 per person annually. Without it, many older Americans on fixed incomes face out-of-pocket prices that are simply unaffordable. That’s not just a financial burden. It’s a prescription for harm.
The Policy Imperative
As policymakers consider reforms to Medicaid eligibility and redetermination processes, the message is clear: keeping people enrolled in LIS saves lives. That means simplifying renewals, reducing administrative churn, and treating LIS access as a critical benefit, not a bureaucratic casualty.
Where RazorMetrics Fits In
While we don’t control who qualifies for LIS, we can help close the affordability gap. Every unnecessary or overpriced medication adds to the burden on state budgets and threatens the sustainability of critical programs for Medicare/Medicaid dual eligible citizens.
RazorMetrics helps by reducing prescription waste through a physician-directed approach that identifies lower-cost therapeutic alternatives, manages polypharmacy, and supports safe deprescribing. Our solution works within physicians’ normal clinic workflow, minimizing disruption for prescribers while delivering measurable savings for states.
By helping State health programs stretch limited dollars, RazorMetrics supports long-term coverage stability and helps safeguard essential benefits for vulnerable populations. The system is complex, but the stakes are simple: affordability equals adherence, and adherence, in many cases, equals survival.
