The first half of this year had 43% of working-age adults without stable insurance, an issue compounded by not just the COVID-19 downturn but by lingering problems with health plan affordability, a new survey finds.
The survey, published Wednesday by the Commonwealth Fund, looks at reasons for instability in health insurance coverage, which has been thrown into disarray due to major job losses from the COVID-19 pandemic.
“Even before the pandemic, people were struggling with inadequate health coverage and mounting medical debt,” said David Blumenthal, president of the Commonwealth Fund, in a statement. “It has never been more important to ensure that all U.S. residents have affordable, comprehensive coverage to survive this pandemic and beyond.”
The survey of 4,272 adults fielded between Jan. 14 and June 5 found that 12.5% were uninsured at the time they spoke. Another 9.5% had some type of a gap in coverage.
Another 21% were effectively “underinsured,” where they had such high out-of-pocket costs and deductibles relative to their income that they could not get affordable care.
The survey also found that half of the adults who spent any time uninsured or underinsured reported problems paying medical bills or were busy paying medical debt.
“A quarter of those who were continually insured and did not meet the threshold for underinsurance also reported problems paying bills,” the report outlining the survey results said.
Commonwealth reported there was not a significant change in coverage inadequacy between the months leading up to the COVID-19 pandemic and the months afterward.
It cautions that could change as the pandemic continues to spread in the U.S.
The people with the highest uninsured rates were people of color and small business workers.
“More than one-third of Latino adults, small business workers and adults with low incomes were either uninsured or spent some time uninsured in the past year,” according to a release on the survey.
The report noted that the number of uninsured and underinsured people is likely to climb as the economy still struggles with the impact of the COVID-19 pandemic.
An analysis from the Urban Institute estimates the pandemic’s job losses will cause 3.5 million more people to become uninsured by the end of 2020.
The latest uninsured data from the Centers for Disease Control and Prevention released last year showed 30.4 million people didn't have health insurance in 2018.
Another ripple effect could be wage cuts and furloughs that could compound the problem.
“Unless there is a significant drop in premiums and deductibles in private coverage, many households will face healthcare costs that take up a growing share of shrinking budgets,” the report said.
The Commonwealth Fund called for a series of reforms to help lower costs, including boosting Affordable Care Act exchange subsidies, banning short-term plans and creating an auto-enrollment mechanism.