Blog Post

Integrated Care Plans Didn’t Boost Medicaid Enrollment for the Poorest Seniors

Chart of the Day: Medicare-Medicaid Plans—Created to Streamline Care for Dually Eligible Individuals—Failed to Increase Medicaid Participation in High-Poverty Communities

November 13, 2025

By:

Christine Weeks

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A bar chart showing Medicaid enrollment rates before and after the rollout of Medicare-Medicaid plans among Medicare beneficiaries age 65+ residing in 20% of ZIP codes with the highest poverty rate for older adults. It shows that, among both the control and treatment groups, the Medicaid enrollment rate decreased following the rollout of integrated plans. It went from 32.5% to 32.4% in the control group, and 33.2% to 33.0% in the treatment group. — **Figure 1.** The graph depicts the Medicaid enrollment rate among older adult Medicare beneficiaries (age 65+) who lived in the 20% of ZIP codes with the highest poverty rates and compares the rates among those living in counties before and after Medicare-Medicaid Plans (MMPs) were implemented and those in counties with no MMPs, before and after MMPs were implemented. Source: Roberts et al, *Medical Care Research Review* 2025.

People eligible for both Medicare and Medicaid are often dropped from Medicaid due to income changes or administrative hurdles. One potential solution, Medicare-Medicaid Plans (MMPs), was expected to increase enrollment because integrated care improves health outcomes and reduces inefficiencies for this vulnerable group.

But the first study to evaluate the effect of integrated plans on Medicaid enrollment failed to show any effect. LDI Senior Fellow Eric T. Roberts and colleagues found that the implementation of MMPs was not associated with a significant increase in Medicaid enrollment among Medicare beneficiaries living in communities with high poverty rates, where Medicaid-eligible individuals disproportionately live.

These findings suggest that the expansion of integrated care plans alone may not meaningfully increase Medicaid enrollment rates. Instead, policies that help Medicare beneficiaries retain Medicaid enrollment might better enhance Medicare-Medicaid integration efforts.

The study, “Effects of Dual-Eligible Integrated Care Plans on Medicaid Enrollment and Retention: Evidence From the Implementation of Medicare-Medicaid Plans,” was published October 2, 2025 in Medical Care Research and Review by Eric T. Roberts, Eliza Macneal, Kenton J. Johnston, José F. Figueroa.