ACA Offers Protection as the COVID-19 Pandemic Erodes Employer Health Insurance Coverage

A woman hangs a closed sign on a shop window.

More than 3 million adults lost employer-sponsored health insurance during the COVID-19 pandemic—but because of coverage options bolstered by the Affordable Care Act (ACA), there was not a corresponding increase in the uninsured rate.


The Issue

The COVID-19 pandemic presents the first major test of how well the Affordable Care Act (ACA) can protect people’s health insurance coverage during a recession, as job losses threaten employer-sponsored health insurance (ESI). According to newly available data from the Urban Institute’s Coronavirus Tracking Survey,1 3.1 million adults lost ESI between March/April and September 2020, but most of them retained some form of insurance with the ACA in place. However, the California v. Texas lawsuit the Supreme Court will hear on November 10, 2020, could put the protections offered by the ACA at risk.

Key Findings

  • The share of adults with employer-sponsored insurance fell from 64.9 percent in late March/early April to 63.4 percent in mid-to-late September, which is equivalent to about 3.1 million adults.

  • The drop in employer coverage did not correspond with a statistically significant increase in the uninsurance rate, which was 11.5 percent in March/April and 11.9 percent in September.   

  • The losses in employer coverage were mostly offset by increases in Medicaid/CHIP and nongroup coverage.


ACA protections prevented a rise in the uninsured rate as millions lost employer-sponsored insurance due to the COVID-19 pandemic.

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.