Image via Shutterstock 5.4 Million Americans Have Lost Health Insurance During COVID-19
Image via Shutterstock

While House Democrats have passed legislation to help address the loss of coverage and prevent future losses, the White House and Republican-led Senate have failed to act.

An estimated 5.4 million Americans who lost their jobs between February and May also lost their health insurance, according to a new analysis from the nonpartisan advocacy group FamiliesUSA.

The estimated increase in uninsured jobless workers represents the largest number of Americans who’ve ever lost coverage in a single year. During the Great Recession, 3.9 million adults lost insurance between 2008 and 2009.

“We knew losses were going to be big, but we didn’t realize that it was going to be historic in the way that these losses are,” said Stan Dorn, who directs FamiliesUSA’s National Center for Coverage Innovation and was the author of the study. 

As historic as the findings are, Dorn’s analysis may even undercount the number of newly uninsured Americans, as his methodology does not take into account workers’ family members, many of whom also lost insurance. Still, what the study found was troubling enough.

Dorn’s analysis found that nearly half of the increases in the uninsured came from just five states—California, Texas, Florida, New York, and North Carolina. In Texas, an estimated 659,000 residents are newly uninsured, driving up the state’s uninsured rate among adults under 65 to a whopping 29%, the highest in the nation.

RELATED: How America’s Health Insurance System Could Make the Coronavirus Outbreak Even Worse

While every state suffered a substantial loss of coverage, five states—Massachusetts, Hawaii, Rhode Island, Michigan, and New Hampshire—saw their number of uninsured residents increase by more than 40%. In Massachusetts, the number nearly doubled, increasing by 93%, while Hawaii saw a 72% surge in its uninsured population. 

Nationally, the report estimates that one in seven U.S. adults (more than 30 million in total) are now uninsured amid the coronavirus pandemic that has claimed the lives of more than 135,000 Americans and infected more than 3 million. 

The uninsured also disproportionately live in states hardest-hit by COVID-19. Nine of the 10 states with the highest uninsured rates are among the 15 states experiencing the nation’s fastest increase in COVID-19 rates, according to the analysis. This could have tangible consequences as cases rise, as Dorn called being uninsured “the first multiplier accelerating the spread of COVID-19.”

“Losing health insurance increases the risks that patients and communities face from COVID-19,” Dorn wrote in the report. “Without comprehensive health insurance, people who do not know they have contracted the virus often delay seeking care because of cost. This endangers their health, risks their survival, and accelerates the virus’s spread to family members, neighbors, coworkers, and customers.”

While the Democratic-controlled House has passed legislation to help address the loss of coverage and prevent future losses, the White House and Republican-led Senate have failed to act. Instead, the Trump administration has reiterated its support for an effort led by Texas and 17 other Republican-controlled states to repeal the Affordable Care Act, in a case set to be heard by the Supreme Court this fall.

RELATED: The GOP Wants to Repeal the ACA During a Pandemic. Democrats Are Trying to Expand Coverage.

President Donald Trump said in May that he wants to “terminate” the ACA, even though doing so would take away coverage from more than 20 million Americans and gut protections for the estimated 135 million Americans who live their pre-existing conditions. Trump has come under intense scrutiny from Democrats and healthcare advocates for his efforts to strike down the ACA.

Dorn expressed similar dismay about the effort. “It staggers the mind that anyone could advocate for taking health care away from tens of millions of people in the middle of the worst public health crisis our country has experienced in a century and the worst economic crash since the end of World War II,” he said.

Michigan Sen. Gary Peters, a Democrat, tweeted about Dorn’s report on Tuesday and how its findings make it even more critical to defend the ACA.

Other lawmakers like progressive California Rep. Ro Khanna used the report as a rallying cry for Medicare for All. “Lose your job and lose your health coverage? What kind of system is that?” Khanna wrote. “The cure is Medicare for All.”

Repeal of the ACA would also roll back Medicaid expansion in the 37 states that expanded the program to cover more low-income adults, even though it’s proven to be a lifeline for millions of Americans during COVID-19. In Medicaid expansion states, only 23% of laid-off workers became uninsured. But in the 13 states that did not expand Medicaid, which include Texas, Florida, and North Carolina, 43% of laid-off workers lost coverage. 

In fact, thanks to Medicaid expansion, four of every five people who have lost their employer-sponsored health insurance during the pandemic are eligible for free coverage through expanded Medicaid programs or the ACA, according to the Kaiser Family Foundation

Many newly uninsured individuals have likely been able to obtain coverage by being added to a family member’s policy, while others are eligible to maintain their employer-provided coverage through COBRA. But to do so requires paying the full-cost of the insurance plan’s premiums, a difficult task considering the cost of those premiums can reach more than $20,000 a year for a family.

House Democrats’ effort, dubbed the HEROES Act, would address this issue by covering the full cost of COBRA premiums for laid-off and furloughed workers. The bill would also increase federal funding for Medicaid in order to prevent states from reducing coverage and provide states with a new Medicaid option with full federal funding to cover COVID-19 treatment for uninsured residents. 

The HEROES Act would also create a special enrollment period for the ACA marketplace, allowing uninsured individuals to enroll in programs immediately. While many newly jobless Americans are eligible to apply due to changes in their employment, creating a new enrollment period would streamline the process and allow others who might not be eligible to enroll until 2021 to instead gain coverage now, an effort Dorn supports.

“It staggers the mind that anyone could advocate for taking health care away from tens of millions of people in the middle of the worst public health crisis our country has experienced in a century and the worst economic crash since the end of World War II.”

“It’s ridiculous that the Trump administration hasn’t opened up enrollment into the exchange,” he said. 

Another bill Democrats passed would also expand coverage and make it more affordable by providing expanded subsidies for healthcare premiums under the ACA and incentivizing states that have not expanded Medicaid under the ACA to do so. 

Senate Majority Leader Mitch McConnell has refused to take up either piece of legislation, even as the number of uninsured rises and evidence of the pandemic’s devastation mounts. 

“That’s just the shocking piece of it—despite these major losses in coverage that are occurring each and every day, Congress has not yet passed and the president has not signed into law a bill that protects families,” Dorn said. 

It’s not just about health care, either. The surging uninsured rate also threatens the economy, and in more ways than one. 

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“We’ve got to recover from this horrible recession that we’re in and the most important thing we can do to recover is to get people healthy,” Dorn said. “If we want to get the economy going again, we’ve got to beat this virus and that means you have to provide health insurance.”

The economic future of the healthcare sector may also rely on addressing the insurance crisis. Before the pandemic, the healthcare industry employed roughly one out of every eight American workers, but the sector has been one of the hardest-hit in the nation, suffering at least 1.4 million job losses this year. Those losses could be exacerbated by masses of newly uninsured Americans who are reluctant to seek out care due to their lack of coverage and fear of costly medical bills.

“If on top of all the losses they’ve experienced, revenue gets choked off because of huge reductions in the number of people with health insurance, that means more hospital layoffs, that means more clinics close their doors, that means more jobs lost in health care, and also the surrounding businesses that depend on a robust private healthcare system,” Dorn said. “If you are worried about health, if you are worried about household financial security, or if you want to see our country recover from this terrible economic crash, you need to protect comprehensive health insurance, which no piece of COVID-19 legislation thus far enacted has done.”

Unless action is taken, things are likely to get worse. As cases rise across most of the country, states are once again beginning to shut down, which could fuel further job losses, and with them, the loss of insurance coverage for millions more Americans. That, in turn, could cause more Americans to delay seeking care, or get care but have to pay for it out-of-pocket and be stuck with exorbitant medical bills. The scenario is a lose-lose. 

“The last thing struggling families in America need right now is to be hit with a pile of unpaid medical bills and that’s exactly what happens when you don’t have health insurance,” Dorn said. “No one should be forced to choose between essential health care and putting food on the table to feed their families and yet that is exactly the choice that millions of us are increasingly facing.”