Uninsurance Rate Held Steady During the Pandemic as Public Coverage Increased: Trends in Health Insurance Coverage Between March 2019 and April 2021   [open pdf - 978KB]

From the Document: "In this brief, we examine changes in health insurance coverage among nonelderly adults ages 18 to 64 during the pandemic [coronavirus disease 2019] using data from the Urban Institute's Health Reform Monitoring Survey (HRMS). Since it was launched in 2013, the HRMS has provided timely information on coverage before data from federal surveys become available (Long et al. 2014). Our analysis focuses on changes in coverage across three rounds of the survey: March 2019; March/April 2020, just after the pandemic caused a steep decline in employment; and April 2021, more than one year after the secretary of health and human services declared a national public health emergency on January 31, 2020. We estimate regression-adjusted changes for the national nonelderly adult population overall, by state Medicaid expansion status, and by annual family income as a percentage of the federal poverty level (FPL). We focus on adults with low incomes targeted by the ACA [Affordable Care Act] Medicaid expansion (with incomes at or below 138 percent of FPL) and adults with moderate incomes eligible for ACA Marketplace premium tax credits (with incomes between 139 and 399 percent of FPL). [...] Between 2019 and 2021, the rise in public coverage helped offset a decline in ESI [employer-sponsored insurance], and unlike in previous recessions, the uninsurance rate did not change. Medicaid and, to a lesser extent, private nongroup insurance sold through the Marketplaces have provided many adults with coverage options following unprecedented job and income losses. However, more than 1 in 10 adults were uninsured in April 2021, including nearly 1 in 5 adults in nonexpansion states."

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