1 in 5 Adults Reporting Job, Coverage Disruption Now Uninsured

June 25, 2020 - COVID-19 led to an uptick in the number of uninsured individuals as companies furloughed or laid off staff to make ends meet. Many of these workers and their families lost coverage as a result, leaving them with potentially high medical bills, according to a new survey.

A new survey conducted by the Commonwealth Fund and SSRS between May 13 and June 2, 2020, found that 41 percent of adults reporting job disruption due to COVID-19 said they or their partner or spouse, or both, had employer-based coverage through the affected job. Among this group of respondents, one of five (about 20 percent) said they or their spouse/partner, or both, are now uninsured.

The survey yielded responses from over 2,200 US adults.

“This survey shows how our piecemeal approach to health insurance coverage in the United States leaves too many people without coverage or just a layoff away from losing it,” said Sara Collins, PhD, VP of Health Care Coverage and Access at the Commonwealth Fund. “Here in the fourth month of COVID-19 related job losses, a growing number of people won’t be able to afford health care in the midst of the worst public health crisis in modern times.”

Yet a significant portion of adults who were furloughed or laid off due to COVID-19 were able to maintain their employer-sponsored healthcare coverage, the survey found. Over half (53 percent) of adults reporting job disruption and having job-based coverage said they and/or their spouse or partner still had coverage through a job from which they had been furloughed.

READ MORE: Hospital Stimulus Funds to Pay for Uninsured COVID-19 Treatment

About 14 percent said that at least one of them had gained coverage through an employer, 10 percent had coverage or were planning to get covered through COBRA, and 7 percent said at least one person had enrolled in Medicaid or an individual-market plan. 

Most of the adults who were able to keep their jobs and/or employer-sponsored coverage, however, were white with incomes over $50,000.

The survey found that Hispanic workers and those with middle and low incomes experienced the highest rates of furloughs and layoffs. About 31 percent of Hispanic respondents reported job disruption, versus 18 percent of white respondents. Meanwhile, 27 percent of adults with incomes under $50,000 a year reported job disruption, compared to 16 percent of those with incomes above that level.

“It has never been clearer how important it is to ensure that all US residents have affordable, comprehensive coverage regardless of their employment status,” Collins stated.

Authors of the survey report suggested that policymakers expand access to coverage for workers and their families by “launching aggressive advertising and outreach efforts” to let individuals who have lost employer-sponsored coverage that they may be eligible for Medicaid or subsidized marketplace coverage. They also called for simpler documentation requirements for the marketplaces’ special enrollment periods and more affordable premiums in the exchanges established by the Affordable Care Act.

READ MORE: Medicaid DSH Payments Cover 51% of Uncompensated Care Costs

But another policy option supported by US adults could ensure workers and their families maintain their employer-sponsored coverage even if they are furloughed or laid off in future public health crises. That option is giving people with employer-sponsored coverage the ability to purchase insurance on their own.

Nearly three-quarters (74 percent) of survey respondents said they believed that people who get health insurance through their employer should have the option of enrolling in government-regulated and -subsidized health plans that offer coverage at a similar cost. Respondents identifying as Democrats were more likely to support this option (81 percent), whereas about two-thirds (65 percent) of Republican respondents found it to be a viable solution.

Another strategy for maintaining access to healthcare coverage that tends to divide individuals by party line is Medicaid expansion.

Authors of the survey report suggested Medicaid expansion in the 14 states that opted not to do so yet as a long-term policy option that could help expand access to healthcare coverage for workers and their families. Alternatively, policymakers could create a federal solution for those who continue to lack access to insurance coverage in those states, they advised.

Workers who have lost their jobs during the COVID-19 recession and live in states that have yet to expand Medicaid are at a disadvantage when it comes to accessing affordable healthcare coverage, researchers at the Urban Institute recently stated.

READ MORE: Adapting Patient-Friendly Medical Billing to a COVID-19 World

In a separate study, they found that, if the additional federal unemployment compensation was not used to determine eligibility for health insurance assistance, 59 percent of non-expansion state workers in the most vulnerable industries would be eligible for assistance compared to 78 percent of their counterparts in expansion states.

Whether the remaining 14 states decide to expand Medicaid following the pandemic and/or lawmakers allow workers to buy their own government-regulated health plans is something providers should pay attention to.

According to estimates from the Kaiser Family Foundation, up to 2 million uninsured individuals may require hospitalization for COVID-19. CMS could pay as much as $42 billion to offset uncompensated care costs for uninsured COVID-19 patients. However, that funding has yet to be allocated and it is only temporary.

Ongoing job losses due to the COVID-19 recession could increase the number of uninsured patients presenting to the hospital after the Provider Relief Fun runs out.