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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

Nov 30, 2021 - Health

FDA panel backs Merck's antiviral COVID pill

The Merck Cherokee Plant in Riverside, Pa. Photo: Paul Weaver/SOPA Images/LightRocket via Getty Images

An FDA advisory panel on Tuesday voted 13-10 to endorse an antiviral pill developed by Merck and Ridgeback Biotherapeutics to treat adults at high risk of becoming severely ill from COVID-19, despite concerns over its effectiveness and safety.

Why it matters: Oral antiviral drugs designed to prevent or treat COVID-19 could be key pandemic-fighting tools, if proven effective, especially as new variants emerge. If authorized, the Merck drug, known as molnupiravir, would be the first treatment of its kind to be made available in the U.S.

Nov 30, 2021 - Health

Omicron variant in the Netherlands before being discovered in South Africa

Travelers from South Africa are tested for the coronavirus on arrival at Schiphol airport, on Nov. 30. Photo: Remko de Waal/ANP/AFP via Getty Images

Dutch health officials announced Tuesday that they have discovered two cases of the new Omicron variant in the country dating back to Nov. 19 and Nov. 23, days before the variant's detection was announced by South African scientists.

Why it matters: Although the Netherlands announced that it had discovered more than 10 Omicron cases last Sunday, the discovery of these new, older cases means the variant was already spreading in Western Europe before Omicron's existence was publicly known.

Omicron variant detected in more countries

The Galeao International airport in Rio de Janeiro, Brazi. Photo: Mauro Pimentel/AFP via Getty Images

Nigeria, Saudi Arabia and South Korea on Wednesday became the latest countries to report cases of the Omicron variant of COVID-19. They followed similar announcements made in Brazil and Japan on Tuesday.

Why it matters: The arrival of the "variant of concern" in more countries underscores the difficulties governments are facing as they seek to reopen economies stalled by nearly two years of pandemic restrictions in the era of global air travel.

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