As millions file for unemployment, many are now dealing with a pandemic-related ripple effect: a massive loss of employment-dependent health and dental insurance across America.
It’s difficult to count just how many Americans have lost insurance. Since Mid-March, about 22 million workers have filed unemployment claims. As the pandemic continues and state workforce offices slowly work through claims, this number is likely to climb. The latest census data shows 55 percent of Americans rely on their jobs for health insurance coverage. Policy think tanks and healthcare consulting firms are now estimating that anywhere from just over 9 million to more than 35 million will lose coverage.
The Economic Policy Institute placed 9.2 million U.S. residents as “high risk” for losing their coverage. Health Management Associates, a consulting firm, estimates that over the course of the pandemic, nearly 12 million to 35 million Americans will lose their insurance. These numbers do not include the 27.5 million Americans who had no health insurance prior to COVID-19.
Under the Affordable Care Act, people experiencing sudden job loss are given a special enrollment period to buy a health plan through the federal insurance marketplace. However, the Trump administration has resisted calls to open the marketplace’s online enrollment system.
As a result, many of these workers are looking towards Medicaid, public insurance for poor Americans, as a fallback. Medicaid has a waiting period, as well as an income threshold. Thresholds and waiting periods vary state to state; in public health emergencies, states tend to expand Medicaid.
While expansion is happening under COVID-19, as the Kaiser Family Foundation reports, implementation varies. Unlike the federal government, states are also obligated to balance their budgets—expanding Medicaid, which is funded through rapidly vanishing tax revenues, can threaten state economies. While Congress has chipped in to cover more costs, experts believe Medicaid will require much more help.
Additionally, some states did not expand Medicaid under the ACA, leaving their residents at a disadvantage. In 13 of those 14 states, people who have no dependent children can’t qualify for Medicaid regardless of how much income they’ve lost due to COVID-19.
For now, workers rely on COBRA, a transitional coverage provider. But premiums on COBRA can be extremely unaffordable. As the Washington Post and health care bloggers report, COBRA’s medical and dental premiums can range from $570 to over $1,500 per month, depending on household size, previous premium, and other factors.
Because of the long wait for Medicaid and the high costs of provisional insurance, many are turning to emergency and low-income clinics. As a result, these clinics are overwhelmed and overworked.
As Washington Post reporting shows, even during absolute lockdowns, clinics are still providing new patients with care. “Even with what Settle calls ‘an absolute lockdown’ on visits that are not emergencies, the clinic has accepted 113 new patients over the past 30 days, compared with 72 during the same period a year ago,” writes The Post. “They are not infected with the coronavirus, though the clinic is doing testing in a tent out back and at a nearby soup kitchen. They just need urgent help.”
Sources: [Axios, 4/1/2020] [Kaiser Family Foundation, 3/2020; 3/13/2020; 4/17/2020] [The Washington Post, 4/16/2020, 4/18/2020] [Health Management Associates, 4/3/2020] [Economic Policy Institute, 4/16/2020]
