Emergency Health Coverage for the Unemployed and Uninsured in Response to the Pandemic and Economic Crisis

Nearly 38 million Americans have filed claims for unemployment insurance, and many more live in households in which someone has lost a job. As a result, nearly 27 million people could lose their employer coverage and become uninsured. Among this group, about half could be eligible for Medicaid, and several million more would be eligible for subsidies under the Affordable Care Act (ACA). However, major gaps in coverage and affordability would remain. If the unemployment rate reaches 20 percent, Oliver Wyman estimates that the number of uninsured will increase by about 9 million people.

To respond to this crisis and help as many people as quickly as possible, this column proposes emergency health coverage for the unemployed and uninsured. This emergency health coverage would build on one of the most popular parts of the ACA—its Medicaid expansion—by automatically enrolling the unemployed into Medicaid. In doing so, it would guarantee immediate coverage for all of the unemployed.

By leveraging the existing Medicaid infrastructure and program rules, it is possible to rapidly enroll the unemployed in coverage in 2020 and 2021. Such a proposal could be paired with reforms that enhance premium and cost-sharing subsidies for higher-income enrollees in ACA coverage—and that could be implemented relatively quickly—in 2021. And after 2021, this proposal could form the building blocks for broader reforms that expand public coverage further and streamline the system. Continue reading.