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Despite surges of unemployment brought on by the pandemic, the country’s uninsured rate might have remained relatively steady this year, according to a new analysis of administrative data by the Kaiser Family Foundation, a health-care think tank.
Substantial Medicaid and Affordable Care Act marketplace enrollment over the past several months could have helped offset employer-sponsored health coverage loss, KFF found, as preliminary Medicaid data charted a 6.1% increase in enrollment between February and July, and managed-care plan enrollment in 30 states rose about 11.3% between March and September.
Individual health-insurance market enrollment remained “fairly steady” over that same period, they added, a change from the overall attrition usually observed. Enrollment through an SEP (special enrollment period, for which loss of job-based coverage is a qualifying “life event”) was up on state exchanges and the federal HealthCare.gov.
Meanwhile, the administrative data showed that employer-based insurance decreases were much lower than overall employment decreases — suggesting that from March to September, around 2 million to 3 million people could have lost their job-based insurance. The researchers emphasized this was a “rough estimate” and that they lacked solid data on self-insured employers.
“ ‘Between many employers maintaining coverage and the Affordable Care Act along with Medicaid serving as a safety net for those who did lose coverage, the uninsured rate in the U.S. does not appear to have risen nearly as much as it could have, given the scale of employment losses.’ ”
One potential reason behind this relatively moderate decline in job-sponsored coverage, according to KFF: Many who lost their jobs — including lower-wage workers, who are less likely to receive employer-based health coverage and have sustained considerable job losses during the pandemic — “likely were never enrolled in coverage through their job in the first place.”
Jobless Americans could also have been allowed to temporarily keep their coverage in many cases, they added, and a (probably small) number of unemployed people might have gone on COBRA, a more expensive option that generally lets workers at companies of 20 or more employees extend their health coverage for up to 18 months after job loss.
“A largely flat uninsured rate would be good news because health insurance coverage rates tend to fall whenever there is an economic downturn in the United States,” the researchers wrote. “The bad news is that, if the uninsured rate has indeed held steady, there are still tens of millions of people without health coverage during the worst pandemic to hit the country in 100 years.”
They are referencing the 1918 influenza pandemic. Some 500 million people, or one-third of the world’s population, became infected with the “Spanish flu.” An estimated 50 million people died worldwide, with about 675,000 deaths occurring in the U.S
However, the AIDS pandemic hit the U.S. in the early 1980s. That virus has infected up to 76 million people worldwide, and 33 million people have died from the AIDS virus, including more than 700,000 people in the U.S. over the last 40 years.
The researchers stressed that plenty of information remains unknown, and that the data they analyzed didn’t factor in variables like population growth and older adults aging into Medicare.
Still, “between many employers maintaining coverage and the Affordable Care Act along with Medicaid serving as a safety net for those who did lose coverage, the uninsured rate in the U.S. does not appear to have risen nearly as much as it could have, given the scale of employment losses,” the authors added.
“ 2021 open enrollment, which began in November, lasts through Tuesday, Dec. 15. ”
A previous analysis published in October by the Commonwealth Fund, a private foundation that supports health-care issues, found that about 7.7 million Americans who lost their jobs during the pandemic had also lost job-based health coverage as of June — along with about 6.9 million dependents covered under those plans.
2021 open enrollment, which began in November, lasts through Tuesday, Dec. 15. Health-policy experts urge people who have lost their job-based health insurance to check their Medicaid eligibility, understand how the marketplace works, consider switching out of COBRA, and be wary of short-term health plans.
Above all, they say, don’t give up — even if the process gets frustrating.
“Health insurance is your ticket to health care in the United States,” Karen Pollitz, a senior fellow at KFF, previously told MarketWatch, pointing out that uninsured people face barriers to getting care and tend to be at greater risk of suffering from medical debt. “It is absolutely worth it to look into these options, and see if one works for you.”
