- Unlike during previous economic downturns, the U.S. uninsurance rate has held steady during the COVID-19 pandemic as enrollment gains in public insurance plans helped offset widespread job losses that pushed people off their employer-sponsored coverage, a report from the Urban Institute funded by the Robert Wood Johnson Foundation found.
- From March 2019 to April 2021, about 5.5 million adults younger than 65 years old reported losing employer-sponsored coverage, while 7.9 million adults reported gaining coverage through government programs, according to the report out Monday.
- The uninsurance rate held steady during that time at 11%, the report found, thanks to increased Affordable Care Act subsidies and a moratorium on Medicaid disenrollment.
Massive job losses last spring stoked fears that a large chunk of the country would lose their health insurance coverage in the middle of the pandemic.
That hasn't been the case so far, as the ACA proved to be a successful safety net, researchers said in the report. Congress too bolstered gains by not allowing people to be pushed off the Medicaid rolls through relief legislation.
The special enrollment period for ACA marketplaces lasting Feb. 15 through Aug. 15 also helped spur enrollment gains, with 2 million sign-ups as of July 15, according to HHS.
Using data from the Urban Institute's Health Reform Monitoring Survey, researchers found that about 65% of adults said they had employer-sponsored coverage in March 2019, and that dropped to 62.3% by April 2021. And while 13.6% of adults said they had public coverage in March 2019, that jumped to 17.5% by April.
They also found the share of adults reporting public coverage increased in all 50 states, though gains were larger in states that expanded Medicaid.
In those states, coverage increased from 14.9% to 19.2% over the study's roughly two-year period. In non-expansion states, public coverage increased from 10.7% to 14.3%.
At the same time, about 38% of adults with low incomes in non-expansion states were uninsured in 2021, compared with about 14% in expansion states.
Maintaining the current uninsurance rate at 11% is crucial and requires protecting coverage for current and potential Medicaid enrollees as the economy recovers and the disenrollment freeze tied to pandemic relief legislation is lifted, researchers said.
CMS, too, is concerned about that hurdle as states face massive backlogs amid coverage gains. The agency said it's extending the timeline states have to complete pending verifications, redeterminations based on changes in circumstances and renewals for Medicaid after the federal public health emergency ends.
It’s still unclear when the PHE will end, as it's been extended several times.