Illustration: Aïda Amer/Axios
Despite layoffs, losses of income and employer-backed insurance during the pandemic, the uninsurance rate did not change between March 2019 and April 2021 thanks to increased enrollment in public coverage, according to a new report out today by the Urban Institute.
But, but, but: More than one in 10 adults (11%) overall were still uninsured in April 2021, including nearly 20% of adults in states that have not expanded Medicaid.
Why it matters: This lack of change in the insurance rate during the pandemic is unlike previous recessions, the report says.
By the numbers: Public coverage gains occurred in states with and without Medicaid expansion. Still, the declines in employer-based insurance and increases in public coverage between 2019 and 2021 were mostly among adults under 65 with low and moderate incomes.
- The number of adults younger than 65 with employer-sponsored insurance coverage dropped from 65% to 62.3%, or a drop of about 5.5 million adults, between March 2019 and April 2021.
- The uninsured rate in states without Medicaid expansion was more than double expansion states in April 2021, at about 18% and 8%, respectively.
State of play: Researchers say several factors from public insurance helped offset the employer insurance losses:
- Expanded Medicaid eligibility under the Affordable Care Act in 37 states and Washington D.C.
- Paused Medicaid disenrollment under the Families First Coronavirus Response Act in 2020.
- An overall rise in Medicaid enrollment during previous recessions.
What to watch: "Maintaining the current uninsurance rate will require protecting coverage for current and prospective Medicaid enrollees as the economy improves and the disenrollment freeze is lifted," the authors write.
Methodology: The brief had approximately 9,000 to 9,500 adults participants in each online survey round, ages 18 to 64, in March 2019, March/April 2020, and April 2021.