The COVID-19 Pandemic: Insurer Insights into Challenges, Implications, and Lessons Learned

Female patient having her teeth examined by dentist.

Entering the COVID-19 crisis on strong financial ground, insurers acted quickly to reduce cost barriers to care for consumers and provide financial assistance to providers, but uncertainty remains on longer term impacts.



The Issue

Even after months into the COVID-19 pandemic, little is known about the experiences of the health insurers who reimburse the health care providers for the care they deliver, as well as insurers’ insights into what the pandemic might mean for public and private insurance coverage, insurance premiums, and benefits going forward.

Key Findings

Researchers interviewed executives from 25 health insurance plans between April and June 2020 to understand insurers’ experiences during the COVID-19 crisis. Key findings include:

  • Insurers appear well-positioned financially to navigate the COVID-19 crisis, at least for now.

  • While insurers expect the economic downturn to have a significant impact on their employer business, to date, most insurers report that their employer block of business remains surprising stable. Still, there are concerns that small employers, in particular, will begin to drop coverage in the coming months.

  • Medicaid enrollment is on the rise, but expected increases in individual market enrollment have yet to materialize in a significant way.

  • Most insurers are concerned that the financial impact of COVID-19 on some medical practices will lead to further consolidation among providers.

  • Though insurers face a significant degree of uncertainty, they believe the crisis will have less of an impact on 2021 premiums than initially feared.

  • Most insurers feel that the COVID-19 crisis has not prompted a need to change benefit designs to any great degree, though they believe telehealth benefits are here to stay.

  • Insurers acknowledge that further changes to the health care system are needed to address health disparities, especially racial and ethnic disparities.


Insurers’ experiences during COVID-19 can inform policies that could improve the United States’ ability to respond to future pandemics, economic downturns, or other disruptions.

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. 

About Georgetown University's Health Policy Institute–Center on Health Insurance Reforms

The Center on Health Insurance Reforms at Georgetown University’s Health Policy Institute is a nonpartisan, expert team of faculty and staff dedicated to conducting research on the complex and developing relationship between state and federal oversight of the health insurance marketplace.