Proposed policy recommendations to mitigate the rise in uninsurance, include expanding Medicaid on a temporary or permanent basis and expanding eligibility for subsidies for marketplace coverage. (Photo: Shutterstock)
As unemployment soars, an estimated 25 million to 43 million people will lose their employer-sponsored health insurance coverage in the coming months, according to a new study. Before the COVID-19 pandemic, about 160 million people nationwide under the age of 65 got their health insurance through their jobs.
Between March 15 and April 25, 30 million people filed for unemployment, and researchers from the nonprofit Urban Institute's Health Policy Center anticipate that number will only climb. The result? The newly unemployed are being left to scramble for health insurance coverage. The researchers estimate that 21 million now-jobless people will get health insurance coverage via Medicaid, 10 million will gain coverage through the marketplace or other private plan, and 12 million will become uninsured.
The states that declined to expand Medicaid eligibility will see larger shares of the uninsured, the researchers predicted.
"More than half of the newly jobless will obtain Medicaid coverage in states that expanded Medicaid under the Affordable Care Act (ACA), while only about one-third will receive Medicaid coverage in the 15 states that have not expanded the program," wrote study authors Bowen Garrett and Anuj Gangopadhyaya.
The researchers also offered proposed policy recommendations to mitigate the rise in uninsurance, such as expanding Medicaid on a temporary or permanent basis, expanding eligibility for subsidies for marketplace coverage or providing subsidies for COBRA benefits. Medicaid's purpose, they note, is "to provide a safety net to people in financial distress, including those with short-term changes in circumstances." But sharply expanding it creates its own set of problems.
"[G]iven that jobless rates may reach unprecedented heights under the COVID-19 pandemic, steep increases in Medicaid coverage will strain state budgets, restricting already limited resources in the very communities hardest hit by the crisis," they wrote.
In response, they suggest the federal government could further enhance its matching rate for Medicaid financing.
Congress when it passed the Families First Coronavirus Response Act in March already upped the amount of matching funds that states receive under Medicaid. But the Urban Institute report suggests that "further increasing the federal matching rate could help provide the critical resources needed to protect the states most in need."
The researchers also note that some people who lose their employer-based insurance may wind up uninsured simply because they don't realize that they're eligible for Medicaid or marketplace-based subsidized coverage.
States should take steps to raise awareness of these programs, and step up their enrollment assistance, according to the study authors. They also recommend creating a national special open enrollment period, regardless of whether a person had prior insurance coverage.
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Jenna Greene
Jenna Greene is editor of The Litigation Daily and author of the "Daily Dicta" column. She is based in the San Francisco Bay Area and can be reached at [email protected].
