New study exposes ‘folly of tying health coverage to jobs’: 7.3 million more uninsured in US by June

A new study out Tuesday estimates that worker layoffs unleashed by the coronavirus pandemic in the United States have already caused more than 1.5 million people to lose their employer-provided health insurance in recent weeks, with another 5.7 million likely to become uninsured by the end of June.

"The COVID-19 epidemic highlights the folly of tying health coverage to jobs. Our health care system saddles people with medical bills when they're least able to afford them because they've been laid off or are too sick to work."

—Dr. Steffie Woolhandler

With a total of 7.3 million newly uninsured American by this summer, the new research—titled "Intersecting U.S. Epidemics: COVID-19 and Lack of Health Insurance"—reveals the devastating consequences of a health system so heavily reliant on employer-based insurance, especially in the face of an unprecedented public health emergency like the current outbreak.

"Millions of Americans are newly vulnerable to financial catastrophe, as we face an epidemic of life-threatening illness," said study co-author Dr. Steffie Woolhandler, a primary care doctor, distinguished professor at Hunter College and lecturer at Harvard Medical School. "The COVID-19 epidemic highlights the folly of tying health coverage to jobs. Our health care system saddles people with medical bills when they're least able to afford them because they've been laid off or are too sick to work. Health insurance in the U.S. is like an umbrella that melts in the rain."

The study was published in The Annals of Internal Medicine,the official journal of the American College of Physicians, the largest U.S. medical specialty society in the U.S. with 159,000 members. Woolhandler and her co-author Dr. David Himmelstein, an internist and distinguished professor at CUNY's Hunter College and lecturer at Harvard Medical School, looked at state-by-state unemployment data to determine estimates about the number of people now out of work who relied on their employer for insurance. According to their report:

We estimated the likely effects of current job losses on the number of uninsured persons by using data from the U.S. Census Bureau's March 2019 Current Population Survey on health insurance coverage rates among persons who lost or left a job. The uninsurance rate among unemployed persons who had lost or left a job was 26.3% versus 10.7% among those with jobs. Applying the 15.6–percentage point difference to the 9.955 million who filed new unemployment claims last week, we estimate that 1.553 million newly unemployed persons will lose health coverage. This figure excludes family members who will become uninsured because a breadwinner lost coverage and self-employed persons who may lose coverage because their businesses were shuttered, but are ineligible for unemployment benefits. If, as the Federal Reserve economist projects, an additional 47.05 million people become unemployed, 7.3 million workers (along with several million family members) are likely to join the ranks of the U.S. uninsured population.

Himmelstein and Woolhandler further argue that their new research "exposes the imprudence of tying health insurance to employment, and the need for more thoroughgoing reform. "

"In this emergency, Congress should make all of the uninsured automatically eligible for Medicare."

—Dr. David Himmelstein

"A trickle of families facing the dual disaster of job loss and health insurance loss can remain under Washington's radar," they continued. "However, the current tsunami of job and coverage losses along with a heightened risk for severe illness demands action."

Dr. Himmelstein said states are too overwhelmed by the catastrophe now unfolding to adequately address the current situation—especially as things get worse, not better in the coming weeks and months—and called for the federal goverment and Congress to step in.

"The states can't do it because tax revenues are plunging, and they're required to balance their budgets," Himmelstein warned. "Congress and the President have provided free testing for coronavirus, but no new coverage for those who need treatment. In this emergency, Congress should make all of the uninsured automatically eligible for Medicare."

The call for lawmakers to immediately open Medicare enrollment has been issued by other progressive voices as well. As Common Dreamsreported earlier Tuesday, Public Citizen and others have said opening the program to the recently unemployed is the easiest and quickest way to provide coverage to those who need it.

"With millions of people losing their jobs because of a pandemic, it's both crazy and immoral for them to be stripped of health insurance," said Robert Weissman, president of Public Citizen. "If we had a Medicare for All system, this kind of problem wouldn't occur. But we can't wait to win Medicare for All. The solution to this immediate problem is to enroll all unemployed people in Medicare."

While expanding Medicare for the out-of-work and uninsured would be a short-term way to stem the pain for millions, advocates for Medicare for All—including Himmelstein and Woolhandler—say that the coronavirus may finally be the catastrophe that wakes the nation up to the need for a permanent solution to its healthcare woes and the unsustainable and inhumane design of the current for-profit system.

"A decade ago," the two researchers concluded in their report, "Victor Fuchs forecasted that 'National health insurance will probably come to the United States after a major change in the political climate—the kind of change that often accompanies a war, a depression, or large-scale civil unrest.' Such a major change may be upon us."