Adults in Families Losing Jobs in the Pandemic Also Lost Employer-Sponsored Health Insurance

Tired young woman lying on a sofa.

Two new analyses provide the first nationally representative estimates of changes in health insurance coverage during the pandemic-related recession and examine who is avoiding health care because of cost or concerns about exposure to coronavirus.

 

The Issue

The recession caused by the COVID-19 pandemic is expected to lead to losses of employer-sponsored health insurance coverage and a rise in uninsurance that would test the health care safety net established by the Affordable Care Act.

Drawing on data from the first wave of the Coronavirus Tracking Survey, a subset of the Health Reform Monitoring Survey (HRMS), researchers find:

Coverage Changes

  • Though health insurance coverage did not change between March/April and May for the overall sample, adults in families losing jobs reported a 4.9 percentage-point decline in employer-sponsored health insurance coverage and a 3.5 percentage-point increase in private nongroup coverage during this period.

  • Among adults in states that did not expand Medicaid under the Affordable Care Act, the overall share of adults who were uninsured increased by 1.4 percentage points. Among adults in families losing jobs in these states, the share with employer coverage fell by 6.2 percentage points, and the share with private nongroup coverage increased by 7.0 percentage points.

  • Among adults in families losing jobs in Medicaid expansion states, the share reporting employer coverage fell 4.2 percentage points, and the share reporting Medicaid/CHIP increased 2.0 percentage points. Uninsurance remained unchanged in these states, both overall and among those in families losing jobs.

Avoidance of Care

  • Almost half (45.5%) of adults in families losing work or work-related income reported unmet need for medical care in their family and/or avoided care because of concerns about exposure to coronavirus in the month before the survey, compared to 30.9 percent in families that did not lose work or income.

  • Among adults in families losing work or income because of the outbreak, more than half of adults with lower incomes and those with uninsured family members, adults in families with chronic conditions, and parents living with children under 19 were in families that avoided care because of either cost or concerns about exposure to coronavirus.

Conclusion

Adults in families who are losing work because of the pandemic’s impact are more likely to face health care affordability challenges. This is one example of how the COVID-19 pandemic is highlighting longstanding structural inequities within society.  

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.