Nearly 8M Americans in danger of losing job-based insurance, Commonwealth Fund analysis finds

A new study found that as many as 7.7 million Americans lost jobs that offer employer-sponsored insurance due to the COVID-19 pandemic, and nearly 7 million dependents could also lose coverage.

The study, released Wednesday from the Commonwealth Fund, comes as providers worry about an adverse payer mix due to the pandemic as patients move away from commercial plans that pay higher reimbursement rates to government programs that offer lower rates.

“This study illustrates how the country’s predominately job-based health insurance system leaves workers and their families at risk of losing coverage during a severe economic downturn,” said Sara Collins, Commonwealth Fund’s vice president for healthcare coverage, access and tracking.

The study does not say how many of the nearly 14 million actually lost health insurance, as it remains unclear how many of the job losses are permanent.

There are several factors that could decide whether the loss of insurance is permanent. These include whether the job loss is temporary or permanent and whether the worker continues to get insurance during a furlough.

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Another factor is whether the worker gets coverage through COBRA, the Affordable Care Act’s insurance exchanges or Medicaid after losing employer-sponsored insurance.

“Only with time will we know how many job losses are ultimately permanent and result in loss of [employer-sponsored insurance],” said Stephen Woodbury, co-author of the report and a senior economist with the Upjohn Institute, in a statement.

Commonwealth Fund looked at the proportion of workers with employer-sponsored insurance compared to the number of workers that lost jobs from February through June, as the COVID-19 pandemic forced major economic shutdowns across the country.

The analysis comes as hospitals are worried about a change in their payer mix, which could contribute to an already precarious financial position due to COVID-19.

A survey of health system and hospital executives released last month found that 70% expect to see an uptick in self-pay and Medicaid patients alongside a drop in commercial plan reimbursement.

The change in payer mix comes after patient volumes plummeted in March and April as hospitals were forced to cancel or postpone elective surgeries, key revenue drivers for facilities. While volumes have rebounded after shelter-in-place orders were lifted, experts predict patient volumes will likely remain below pre-pandemic levels for the near future.