Coronavirus: 3.5 million workers could lose health insurance amid unemployment surge as Trump blocks access to Obamacare

Out-of-work Americans could lose insurance tied to their employer as costs for Covid-19 care skyrocket

Alex Woodward
New York
Friday 03 April 2020 09:02 BST
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Almost 10 million Americans have filed for unemployment in the past two weeks, including a record 6.6 million claims within the last week alone.

The unprecedented unemployment numbers offer only a glimpse at the overall jobs picture in the economic fallout in the wake of the coronavirus pandemic, and analysts predict the numbers will continue to spike to as many as 20 million claims by the end of April.

From unemployment claims in March, analysts estimate roughly 3.5 million people lost their employer-based health insurance in the middle of the national health emergency, according to the Economic Policy Institute.

With most health plans administered on a monthly basis, thousands of Americans and their families were likely cut off from their health insurance on 1 April.

Donald Trump has indicated that he will not reopen the federal health insurance marketplace through the Affordable Care Act for a special enrolment period, leaving many Americans without any coverage as they potentially face thousands of dollars in out-of-pocket expenses if they fall sick.

Unemployed people could be eligible for Medicaid, which serves poor Americans, though it's unclear whether states are likely to support a massive surge in claims without significant federal support.

At a White House briefing on Thursday, the president said: "I will always protect your Social Security, your Medicare, and your Medicaid."

His current budget includes sweeping cuts for all those programmes, and his administration is challenging the Supreme Court to remove the ACA's Medicaid expansion provision.

On Thursday, Vice President Mike Pence said the administration will "find a way" to pay for the coronavirus treatment of uninsured people. He said an announcement will come on 3 April.

The Economic Policy Institute has urged the White House to extend the open enrolment period for the 38 states that have access to Affordable Care Act insurance exchanges

Eleven of 12 states that run their own healthcare exchanges, including Washington DC, already have opened a special enrolment period.

Roughly half of the US workforce gets their insurance through their employer or through an employer-sponsored plan available to someone in their family. Without those jobs, they also can lose their health insurance.

The institute notes that its calculations "might understate the loss of health insurance coverage because they do not account for family members who are no longer covered because of the policyholder's layoff. And because not all layoffs result in [unemployment insurance] claims, we will underestimate the actual magnitude of job losses."

Whether people are covered or not, the costs for coronavirus care can be devastating.

People who are hospitalised for Covid-19 can expect to pay up to $74,310 for treatment if they're uninsured, or if their provider has determined the care they receive is out-of-network, according to an analysis by FAIR Health.

But insured patients using In-network providers could spend as much as $38,755, the group found.

The surge of patient care is expected to skyrocket health insurance premiums in 2021 by more than 40 per cent, with 170 million Americans on private insurance spending as much as $251 billion on healthcare costs within the pandemic's first year, according to Covered California, the state's health insurance marketplace through the ACA.

Peter Lee, director of Covered California, says that "absent federal action, consumers, employers and our entire health care system may be facing unforeseen costs" that could exceed $250 billion.

More than 3.3 million of the unemployment claims made in the last two weeks are from service industry workers, following the forced closures of restaurants, bars, hotels, gyms, theatres and other front-facing businesses across the US. The Economic Policy Institute estimates that nearly 800,000 of those workers had health insurance through their employer.

Initial unemployment insurance claims jumped from 211,000 in the first week of March to more than 6.6 million at the end of the month, a 3,000 per cent increase within three weeks.

Congress extended unemployment insurance with the passage of a $2.2tn relief measure, which adds $600 a week in benefits in addition to what filers receive through their respective state systems. The measure also expands eligibility for self-employed people and "gig economy" workers.

Wendell Potter, a former health insurance executive turned whistle-blower and Medicare for All advocate, said that "tying our health coverage to employment status will literally strip people of healthcare [and] get some killed. There's simply no viable argument against it: America needs Medicare For All."

The Economic Policy Institute also urged the federal government to extend Medicaid and Medicare through the crisis.

The group said: "At a minimum, all Covid-19-related care should be covered by the federal government at no cost to patients. However, we should also think about how to hold harmless workers who lose [employer-based health insurance] due to Covid-19 and then find themselves facing expensive medical bills because of other health ailments that would have been covered by their previous employer plan. A bolder and comprehensive policy would be to extend Medicare and Medicaid to all those suffering job losses during the pandemic period, with the federal government funding this expansion."

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