Medicaid expansion buffered health coverage loss during pandemic

Unemployment-related health insurance coverage loss during COVID-19 was higher in states without Medicaid enrollment, whereas Medicaid enrollment occurred more often in Medicaid expansion states, according to a study published online June 17 in JAMA Health Forum.

Joseph Benitez, Ph.D., from the University of Kentucky in Lexington, compared changes in health insurance coverage status associated with pandemic-related unemployment among adults who were employed at baseline during calendar years 2019 to 2020. The cohort included 16,231 adults (mean age, 46.8 years) with new unemployment experienced during 2020.

Benitez found that new unemployment was associated with a 2.9 and 10.7 percent increase in the proportion of uninsured adults in Medicaid expansion states and nonexpansion states, respectively. Compared with workers experiencing job loss in nonexpansion states, workers who lived in Medicaid expansion states were 5.4 percent more likely to enroll in Medicaid after a job loss.

"The COVID-19 pandemic created unprecedented risks for becoming uninsured among working adults," Benitez writes. "Leveraging a longitudinal database allowed monitoring of transitions in health insurance coverage status and source among working adults before and during the pandemic."