Are Millions Without Insurance During This Pandemic?

The estimated increase in uninsured workers was about 40% higher than the highest previous increase that occurred during the recession of 2008 -2009 when 3.9 million lost their insurance, according to the report from the nonpartisan consumer advocacy group Families USA, who noted that definitive data will not become available until mid to late 2021 when the federal government releases the health insurance estimates for 2020. 

“We knew these numbers would be big,” said Stan Dorn, who directs the group’s National Center for Coverage Innovation and wrote the study. “This is the worst economic downturn since World War II. It dwarfs the Great Recession. So it’s not surprising that we would also see the worst increase in the uninsured.”

27 million Americans were estimated to have lost their insurance coverage by the nonpartisan Kaiser Family Foundation, their study took into account family members of the insured. 

A report published by the Urban Institute and the Robert Wood Johnson Foundation has projected that by the end of 2020 over 10.1 million Americans will no longer have employer sponsored health insurance or coverage that was linked to a job they have lost. 

All of these people who have lost and will be losing their coverage, plus the ones who didn’t even have insurance at all before, could face some staggering costs if they fall ill with COVID-19 which can send a seriously ill person to an ICU in hospital for weeks to months. 

4 out of every 5 Americans who have lost employer provided health insurance may be eligible for free to cost varying coverage through expanded Medicaid programs or governments subsidized private insurance through the Obama-era health law, according to the Kaiser Family Foundation. 

Insuring the recently unemployed can be challenging as many are not able to afford the premiums for coverage whether it be through the healthcare law or the COBRA program, along with that some may not qualify or even be aware that they may be eligible for Medicaid. 

The administration may have added to the issue by imposing cuts on the funding for outreach programs to assist those signing up for coverage under the health law: legislation intended to help people keep their health insurance passed by the House is waiting in the Senate to be reviewed. The President has promised to directly reimburse hospitals for the care of COVID-19 patients that lost their insurance, whether that happens remains to be seen yet but does not necessarily mean it won’t. 

“Helping people keep their insurance through a public health crisis surprisingly has not gotten much attention,” said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. “This is the first recession in which the A.C.A. is there as a safety net, but it’s an imperfect safety net.”

The Families USA study is an examination of the effects of this pandemic going state by state of adults under the age of 65, as Americnas become eligible for Medicare at the age of 65. This study found that 46% of the coverage losses came from 5 states: New York, California, Texas, North Carolina, and Florida. 

The number of uninsured increased from 4.3 million to 4.9 million in Texas alone, where 3 out of 10 people are now uninsured. Within the 37 states that expanded Medicaid under the Affordable Care Act 23% of laid off workers became uninsured and this was nearly doubled in the 13 states that did not expand Medicaid to 43% which includes Florida, North Carolina, and Texas. 

5 states have experienced increases in the uninsured that exceed 40%, such as in Massachusetts where that number has nearly doubled by increasing 93% which has been attributed to a large number of people losing employer based coverage. As a whole across the country more than 1 in 7 American adults are estimated to now be without health insurance, according to the analysis. 

To create the estimates the number of laid off workers in each state were examined to calculate how many  had become uninsured based on coverage patterns generated since 2014 when the central provisions of the Affordable Care Act went into effect; the underlying data for the patterns comes from work published by the Urban Institute. 

Analysts will be able to generate a clearer picture next year when the federal government releases the health insurance estimates, but according to the report in the meantime “policymakers need to know now what the approximate magnitude is of insurance losses to decide what they need to do. So this is our best estimate for what the actual coverage losses have been.”

Health care advocacy groups suggest that the importance of having health insurance coverage extends beyond personal well being, especially in a time of recession and pandemic as those who are without insurance tend to avoid seeking medical assistance or going to the doctor which could expose others to an infection or illness. As such these groups are calling for the federal government to provide financial assistance to those who have lost their jobs due to the outbreak to maintain their coverage through COBRA, and to give states an incentive to expand Medicaid by increasing the federal share of costs. 

“Taking steps like these to help people get access to health care during a pandemic shouldn’t be controversial, it should be common sense, and we should be doing it right now instead of waiting for things to get even worse,” said Ms. Murray.