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Millions Of Americans Have Lost Health Insurance As Unemployment Soars


If there's any time people would really need access to health care and health insurance, it's during a global pandemic. But here are some tough facts. In the U.S., 33.5 million people have filed for unemployment benefits, and most people in this country get their health insurance through their jobs. A new report from the Kaiser Family Foundation estimates that 27 million people have recently lost their health coverage. NPR health policy reporter Selena Simmons-Duffin is here to talk through this with us. Hi, Selena.


MARTIN: All right. So 27 million people - that is a lot of folks losing their health insurance. And the question is, I mean, how long will they be uninsured? Is it going to be long term?

SIMMONS-DUFFIN: Well, there's so much uncertainty here. We have no idea how long these job losses or this insurance loss is going to last. But this report found that, in fact, most people who've recently lost coverage are eligible to get health insurance somewhere else - so mostly by enrolling in Medicaid, which is essentially free for people who are eligible, or a plan on the Obamacare insurance exchanges with a tax subsidy to make the premiums more affordable. So the report authors estimate that about 6 million people do not have those options and are likely to join the ranks of the uninsured for some longer period of time.

But even though a lot of people could get coverage, a big question mark here is how many actually will. Health insurance is complicated and signing up is hard. Here is what one of the authors of the report, Larry Levitt, told me.

LARRY LEVITT: There's a lot of stressors on people right now. You may be unemployed. You might be sick. You might be quarantining. And, you know, there's just a limit to how many life things you can deal with at once.

SIMMONS-DUFFIN: Even though it's overwhelming, there is a time crunch here. If you've lost coverage, that is what's called a qualifying life event. So you can go to healthcare.gov if your state uses that for its insurance exchange, show you've lost your coverage and enroll in a new plan, but that all needs to happen within 60 days of losing coverage. So for people who lost their coverage in March, at the beginning of all of this, the clock is ticking.

MARTIN: I mean, has the federal government advertised that fact? I mean, that seems to be fairly important that there's a time horizon; people need to go sign up.

SIMMONS-DUFFIN: Right. No, the answer is they really haven't. The Affordable Care Act, which expanded Medicaid in many states and created these insurance exchanges, is President Obama's trademark law, and President Trump has made getting rid of Obamacare a major priority during his first campaign and as president.

So now the Trump administration is arguing before the Supreme Court that the law should be struck down, and funding for navigators who can help people sign up and advertising for these insurance exchanges has been dramatically cut. And the White House decided not to pull a big lever it could use to get more of these millions of newly uninsured people into the ACA exchanges by creating a federal special enrollment period so that no matter where you live, you don't need a qualifying event; you can just sign up. The decision not to do that could really impact how many people access this coverage and how many people do become uninsured longer term.

MARTIN: Although, instead, the federal government does plan to pay hospitals directly for the care of uninsured people with COVID-19. Is that right?

SIMMONS-DUFFIN: Right. That's significant. But Larry Levitt of the Kaiser Family Foundation points out that is only for the treatment of COVID-19. Here's what he said.

LEVITT: While COVID-19 is a very present risk right now in a lot of people's minds, you know, people have health care needs that go beyond the coronavirus.

SIMMONS-DUFFIN: If you end up with cancer, for instance, or a burst appendix and you're uninsured, that could be financially ruinous. But, Rachel, I want to make sure we don't lose that, in all of this, it's not all bad news. There is a silver lining in this report.

MARTIN: (Laughter) OK. OK, good. We need one. Tell me.

SIMMONS-DUFFIN: Well, that's just that the vast majority do have options. And that hopeful note was what stuck out to Sabrina Corlette of Georgetown University when she looked at the report. Here's what she told me.

SABRINA CORLETTE: To me, the takeaway from this report is that the Affordable Care Act is serving as the safety net it was intended to be, which during a health crisis like COVID-19 is just so, so critical.

SIMMONS-DUFFIN: She just noted that a lot of people might not be trying to sign up for coverage...


SIMMONS-DUFFIN: ...Because it's such a hassle, and they're hoping that their jobs and their coverage might all just come back and this all might be temporary.

MARTIN: We hope. NPR's Selena Simmons-Duffin. Thank you.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.

Selena Simmons-Duffin reports on health policy for NPR.
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