En español | At least six million Asians, African Americans and Hispanics could lose their employer-based health insurance this year because of job losses during the coronavirus pandemic, according to a new study, which also indicates these losses could hit older individuals the hardest.
The COVID-19 pandemic is exacerbating existing inequalities in health care coverage among racial groups in America, according to an analysis by Avalere, a nonpartisan health care consulting firm. Job loss, which has been greatest among minority groups during the crisis, is the largest driver of insurance coverage losses. While employment declined 13 percent nationally from February to April, the study says, it decreased 18 percent among Asians, 17 percent among Hispanic workers and 15 percent among African Americans, compared to 11 percent among white employees.
Avalere's analysis finds that while 6 percent of whites are expected to lose their job-based health insurance due to the pandemic, that percentage is about double for other racial groups: 10 percent fewer Asians (one million), 13 percent fewer Blacks (two million) and 13 percent fewer Hispanics (three million) are predicted to be enrolled in health insurance through their work this year.
The impact of this increase in the number of uninsured Americans could particularly affect older Americans and have a negative economic impact on the nation's health care system, according to one of the authors of the study.
"When you're 50-plus or 60-plus, it's harder to restart your career when you've lost your job,” says Chris Sloan, associate principal at Avalere. And that means many in that age group may have to take part-time or freelance jobs that don't come with health insurance. “It can also be more devastating when you lose coverage because individuals 50-plus are more likely to use their coverage and more likely to need it."
With more people uninsured, Sloan says that means hospitals could have to treat more people in their emergency rooms — care that won't be paid for. And, people without insurance will likely forgo routine preventive care, which could lead to more severe illnesses that will be expensive to treat in the long run.
"It's going to be a slow recovery, so the effects of this are going to be felt for a long time,” Sloan says.
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Affordable health insurance options are limited
The effects of this disparity will be compounded because of the lack of affordable alternatives for many minority groups. Unemployed and low-income individuals can turn to Medicaid, the federal-state health insurance program for low-income individuals. But, Sloan says, the very states that have not expanded Medicaid under the Affordable Care Act (ACA) — including Florida, Texas and other southern states — are places with large numbers of Black and Hispanic residents.
In addition, while people who lose their insurance because of being laid off from their job can immediately go to the ACA for coverage — and likely be eligible for federal subsidies to help pay the premiums — Sloan points out that often the unemployed cannot afford any premiums or the deductibles and other out-of-pocket costs that they would need to pay for health care.
The extra $600 that many of the unemployed received earlier this year may have helped them afford health insurance, Sloan says, but with that having expired, their ability to afford health insurance has decreased.
Even those who are able to get new health insurance, whether Medicaid or through the individual market, may find they have less access to care, the Avalere analysis finds. Most plans in the individual market, the study says, have narrower networks than are available through job-based insurance. And, only 71 percent of doctors accept new Medicaid patients, “presenting further access barriers to patients shifting into Medicaid enrollment,” the study says. “These challenges may prevent continuity of care for some patients, further increasing the negative impact of the pandemic."