After Pandemic, Health Insurance for Those Losing Medicaid Results in Employer Coverage

Almost a wash according to a recent study. The study provides timely insights on a shift in health insurance coverage among working-age adults after the restart of Medicaid eligibility redeterminations in April 2023. As expected, one study documented large and significant declines in Medicaid coverage post-unwinding.

Contrary to some expectations, the study found no statistically significant net reduction in the overall health insurance coverage. This was largely because of the availability of Employer Sponsored Insurance (ESI) and increases in private coverage without ESI. The findings help abate some of the concerns of large reductions in Medicaid coverage after redeterminations leaving many people uninsured.

This was a finding in a recent study by Sumedha Gupta, Christopher Behrer, Velda Wang, Jessica S. Banthin, and M. Kate Bundorf. The study is in Health Affairs, “Resumption of Medicaid Eligibility Redeterminations: Little Change In Overall Insurance Coverage.”

I am not going to post the whole study at AB. An initial summation is in the Abstract early on in the study. Just a commentary from the study and a few comments by me.

In the Abstract

“Using data from the Census Bureau’s Household Pulse Survey, we estimated the early effect of Medicaid unwinding on insurance coverage among people ages 19–64. We found that within the first three months of unwinding, the number of people self-reporting Medicaid coverage declined by approximately two million, and there was a much smaller, statistically insignificant decline in overall coverage of approximately 467,000 people.

It appears that for many people, the availability of employer-sponsored insurance and other private coverage offset Medicaid coverage loss. These results suggest that the resumption of redeterminations has had less impact on uninsurance than was initially feared. Our findings highlight the importance of tracking coverage transitions during unwinding. By identifying populations at risk for uninsurance after Medicaid loss, these data could enhance the effectiveness of state outreach and enrollment assistance for people eligible for Marketplace coverage and subsidies.“

A summation to this may be . . . many people determined not being eligible for Medicaid any more and after the government program ended, returning to their occupations. In turn, they were covered by Employer Sponsored Insurance.

In the Abstract:

Within the first three months of unwinding, the number of people self-reporting Medicaid coverage declined by approximately two million, and there was a much smaller, statistically insignificant decline in overall coverage of approximately 467,000 people.

Conclusion:

As expected, we documented large and significant declines in Medicaid coverage post-unwinding. Contrary to some expectations, we found no statistically significant net reduction in overall insurance coverage, largely because of the availability of ESI and increases in private coverage without ESI. Our findings help abate some of the concerns that large reductions in Medicaid coverage after redeterminations would leave many people uninsured.

Our findings highlight the importance of tracking coverage transitions during unwinding. By identifying populations at risk for uninsurance after Medicaid loss, these data could enhance the effectiveness of state outreach and enrollment assistance for people eligible for Marketplace coverage and subsidies.

One aspect not said and hinted at, being; more employers have healthcare insurance for their employees which may not have existed previously pre-pandemic. This only became available because of government programs. Once employers opened open their businesses, employees returned to work and received healthcare coverage again.