Unemployment, Health Insurance, and the COVID-19 Recession

Store closed sign.

Coronavirus pandemic likely to impact the livelihoods of people in America.

The Issue

The sharp reduction in U.S. economic activity associated with public health efforts to slow the spread of the COVID-19 virus is likely to result in millions of people in America losing their jobs and livelihoods, at least temporarily. Many people who lose their jobs during this health and economic crisis could also lose their health insurance. Researchers compared health insurance coverage for working-age, unemployed adults with employed adults and people not in the labor force across three time periods: The Great Recession and high unemployment (2008-2010), the ensuing economic recovery (2011-2013) and implementation of the ACA’s major insurance coverage provisions (2014-2018).

Key Statistics

Researchers found that 46 percent of unemployed people did not have health insurance in 2011-2013 before full ACA implementation.

  • After ACA implementation and an improved economy, 29.8 percent of unemployed individuals did not have health insurance—a more than 35 percent decrease.

  • Reductions in uninsured rates were greater in Medicaid expansion states relative to nonexpansion states, where newly unemployed adults without dependent children are ineligible for Medicaid, currently.


Findings indicate that though joblessness will likely affect uninsurance rates throughout the country, states that did not expand Medicaid under the ACA will see larger increases in uninsurance if current policy fails to adapt to the COVID-19 virus. Medicaid coverage will sharply increase as workers become unemployed due to the pandemic, particularly in Medicaid expansion states.


About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.