Uninsured Projections from Kaiser Family Foundation due to Rising Unemployment
At least 33 million Americans have lost their jobs in the last two and one half months. Many had employment-based coverage for their families as well, and Kaiser Family Foundation projects that health coverage for 78 million American workers, their spouses and their children will be impacted.
Kaiser estimates that 61% of those losing jobs had employment-based coverage, 17% had Medicaid, 7% purchased individual coverage (primarily through Exchanges), 6% had military coverage and 9% were uninsured.
Kaiser projects that 27 million Americans are at risk of becoming uninsured. Of those 27 million, 12.7 million may qualify for Medicaid (MediCal), and 8.4 million could qualify for subsidized coverage through the Exchanges (Covered California). That means 5.7 million Americans are not eligible for any financial help: 3.7 million will have incomes too high to qualify for subsidized coverage in Exchanges (over 400% of FPL), 530,000 do not meet citizenship or legal residency requirement (e.g. the undocumented workers), 150,000 are in the Medicaid coverage gap (states like Florida and Texas that did not expand Medicaid under the ACA) and 1.3 million could be eligible for employment-based coverage as a dependent through another family member’s employment-based coverage plan. An additional 3 million Americans filed for UI benefits this week, so these numbers just went up by another 9%.
When the newly expanded federal eligibility for unemployment insurance (UI) ends next January, 2021, 16.8 million will be eligible for Medicaid, and 6.2 million for subsidized Exchange coverage. About 2 million will be in the Medicaid coverage gap (i.e. the state refused the 90% FFP to expand Medicaid), 1 million will have incomes too high to qualify (in California this share will be less as the state expanded premium assistance to 600% of FPL) and 500,000 will not be eligible due to immigration status (in California this share will be less because undocumented children and adults up to age 26 can qualify for MediCal regardless of immigration status).
Advocates and others will need to explain and help all these millions of people apply for Medicaid (MediCal in California), subsidized coverage in the Exchanges (Covered California here) and as a last resort COBRA (you pay full premium cost to keep your employer’s coverage) or individual coverage (you pay full premium cost for this as well). There is a tight timeline of 60 days after losing coverage in which to apply for programs like Covered California or individual coverage, so act very quickly. If you do become uninsured and you contract Covid 19, you need to see your provider immediately and alert your provider about its ability to be reimbursed by HHS for the costs of your Covid tests and treatments under the CARES Act and Families First Act. Your doctor must be a Medicare participating doctor to qualify for these reimbursements at Medicare rates.
Meanwhile the Trump Administration and 15 Republican Governors are asking the Supreme Court to find that the Affordable Care Act is unconstitutional and must be terminated. In addition, states are running huge deficits due to Covid 19; their tax revenues have dried up, and their citizens’ needs for state funded services like UI and Medicaid have exploded.
Senator McConnell has suggested states declare bankruptcy. President Trump has stated only “blue states” will be running deficits; (boy is he in for a surprise). Speaker Pelosi has put forward a relief package of $3 trillion to be voted on this week in the House that includes relief for the states and local governments ($1 trillion), extension of UI coverage and other elements that I will summarize in a separate blog posting.
Prepared by: Lucien Wulsin
Dated: 5/13/20