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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:

  1. Expanded Medicaid eligibility under the Affordable Care Act in 37 states and Washington D.C.
  2. Paused Medicaid disenrollment under the Families First Coronavirus Response Act in 2020.
  3. 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.

Go deeper

Oct 22, 2021 - Health

Illinois mandates daycare workers to receive COVID vaccine or weekly testing

Illinois Gov. J.B. Pritzker speaks during a round table discussion with high school students in October 2018. Photo: Joshua Lott/Getty Images

Illinois Gov. J.B. Pritzker (D) announced Friday that all daycare workers in the state will be required to receive the COVID-19 vaccine or or submit to weekly testing.

Driving the news: Pritzker said he was issuing the requirement to protect "babies, toddlers, and young children not yet eligible for the vaccine."

Oct 22, 2021 - Health

CDC director: U.S. may change definition of "fully vaccinated" as boosters roll out

CDC Director Rochelle Walensky. Photo: Greg Nash-Pool/Getty Images

Rochelle Walensky, director of the Centers for Disease Control and Prevention, said Friday the U.S. "may need to update" its definition for what it means to have full vaccination against COVID.

The big picture: The CDC and the FDA have officially approved boosters with every authorized vaccine in the U.S. for people who meet specific requirements. Walensky explained that since not everyone is eligible for a booster, the definition has not been changed "yet."

"Atmospheric river" to whiplash Northern California from drought to flood

A map depicting 24-hour preciptation forecast (inches) ending Monday at 5a.m. local time. Photo: NOAA

A series of powerful "atmospheric river" storms are set dump historic amounts of rainfall across parts of drought-stricken California and the Pacific Northwest from this weekend, forecasters warn.

Why it matters: A strong atmospheric river, packing large amounts of moisture, is predicted to whiplash Northern California from drought to flood.

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