Five. Point. Four. Million. That's how many people Families USA estimates to have lost their health insurance with their employment in the coronavirus pandemic—and that's just up until June. This is the biggest increase in insurance loss ever, bigger than the great recession when 3.9 million lost their insurance over a full year. This time around 5.4 million lost their insurance in just four months.
"We knew these numbers would be big," Stan Dorn, study author and director of Families USA's National Center for Coverage Innovation told The New York Times. "This is the worst economic downturn since World War II. It dwarfs the Great Recession. So it's not surprising that we would also see the worst increase in the uninsured." What's more surprising is that so far the government hasn't done much about it, other than the Trump administration's lawsuit at the Supreme Court to overturn the Affordable Care Act. Oh, right. That's not doing anything to help—that's making the whole situation worse!
Almost half of the coverage losses came from just five states: California, Texas, Florida, New York, and North Carolina. That was before the post-reopening surge of cases in all of those states but New York. As of the beginning of June, three out of every 10 Texans was uninsured—4.9 million people in total. Texas did not expand Medicaid and already had a high uninsured rate, about 4.2 million before the pandemic. Medicaid expansion is a key factor in at least reining in insurance loss, Families USA found. In the 37 states that expanded Medicaid, 23% of laid-off workers became uninsured. In nonexpansion states, it was 43%.
Four states and Washington, D.C. extended open enrollment in the Affordable Care Act because of the pandemic: California, open through July 31; Massachusetts, open through July 23; Vermont, through Aug. 14; and District of Columbia, open through Sept. 15. The Trump administration still hasn't opened enrollment back up for everyone, but is operating under the often confusing special enrollment rules for people with life changes. It leaves many people—like those who were previously uninsured and are now also unemployed—out. The picture of who is uninsured is hard for policy makers to suss out, as Families USA points out in the report, because "they do not know how many people are becoming uninsured and how many are retaining coverage by shifting to insurance offered by a spousal employer, Medicaid, or the individual insurance market." That data won't be available for at least another year, and the crisis is happening right now.
Despite the depth of this crisis, nothing has been done legislatively to protect comprehensive health insurance and make it available and affordable to everyone. Families USA is calling for Congress to fill the gap in the next coronavirus relief bill by including protections for comprehensive health insurance, like those in the House-passed HEROES Act. It would provide full premium subsidies for laid-off and furloughed workers offered employer coverage, including through COBRA. It would provide incentive for states that haven't expanded Medicaid to take it by having the federal government pick up the whole tab and give all states enhanced federal matching rates in exchange for states agreeing not to reduce coverage. States that are facing revenue shortfalls because of the crisis have been looking for places to cut spending, and Medicaid is a big one. The HEROES Act would also open the federal health exchange to new enrollments for everyone who would qualify.