Analysis: Don't expect the full picture of COVID-19 coverage losses any time soon

While a number of studies aim to estimate the impact of COVID-19, the full extent of any coverage losses will likely not be understood until next year, a new analysis shows.

Researchers at the Urban Institute compared four papers that aimed to estimate the pandemic's impact on employment and the employer-sponsored insurance market, including two of their own analyses and one each from the Kaiser Family Foundation and Families USA.

The estimates are quite disparate. KFF, for example, estimated 31 million job losses and 27 million workers and dependents losing employer-sponsored coverage. Families USA, by contrast, projected 21.9 million job losses and that 5.4 million workers would drop out of employer plans.

The researchers say the early data suggest job losses and the resulting coverage losses are not as high as previously anticipated; however, it's unlikely that the full picture comes to light until far-reaching federal household surveys are released next year.

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There are several caveats, though, the authors warn. For one, those federal surveys have a relatively small sample size that could obscure broader trends.

"Though these surveys provide estimates in a more timely way, their smaller sample sizes and shorter questionnaires provide more limited insights into how coverage is changing," the Urban Institute researchers wrote. 

In addition, though employment did improve over the summer compared to the initial wave of social distancing, the pandemic isn't over. As the U.S. continues to navigate a response to COVID-19, the economic impacts could be felt into mid-2021, potentially pushing full estimates of the impact into 2022.

More complete and authoritative data on enrollment in Medicaid and the Affordable Care Act's exchanges are also coming down the pike, which will also be critical in filling in the gaps in researchers, Urban Institute said.

"Over the coming months, we will also learn about increases in Medicaid and marketplace enrollment from administrative data released by state and federal agencies and insurers," the researchers wrote. "Higher enrollment rates in those two programs may reflect two trends—reductions in income due to job loss and reductions in employer-provided health insurance."