Bundorf M Kate, Banthin Jessica S, Kim Christine Young, Gupta Sumedha
M. Kate Bundorf (
Jessica S. Banthin, Urban Institute, Washington, D.C.
Health Aff (Millwood). 2023 Jan;42(1):130-139. doi: 10.1377/hlthaff.2022.01070.
The health risks of COVID-19, combined with widespread economic instability in the US, spurred Congress to pass temporary measures to improve access to health insurance. Using data from the Household Pulse Survey, a high-frequency, population-based survey, we examined trends in health coverage during 2021 and early 2022 among nonelderly adults. We estimated that eight million people gained coverage during this period, primarily because of increases in Medicaid and other public coverage. Despite rising employment, rates of employer-sponsored coverage remained flat. In Medicaid expansion states, employment rates increased significantly among Medicaid enrollees. Our results suggest that when the public health emergency ends, many people currently enrolled in Medicaid might no longer be eligible, particularly in Medicaid expansion states. Policy makers and employers should be prepared to help people who lose Medicaid eligibility identify and navigate enrollment in alternative sources of health insurance, including both Affordable Care Act Marketplace and employer-sponsored coverage.
新冠疫情带来的健康风险，再加上美国普遍存在的经济不稳定状况，促使国会通过了临时措施，以改善医疗保险的可及性。我们利用基于人群的高频家庭脉搏调查数据，研究了2021年至2022年初非老年成年人的医保覆盖趋势。我们估计，在此期间有800万人获得了医保覆盖，主要原因是医疗补助计划（Medicaid）及其他公共医保覆盖范围的扩大。尽管就业人数有所增加，但雇主提供医保的覆盖率仍保持平稳。在医疗补助计划扩大的州，医疗补助计划参保人的就业率显著提高。我们的研究结果表明，当公共卫生紧急状态结束时，许多目前参加医疗补助计划的人可能不再符合资格，尤其是在医疗补助计划扩大的州。政策制定者和雇主应做好准备，帮助那些失去医疗补助资格的人确定并顺利加入其他医疗保险来源，包括《平价医疗法案》市场计划和雇主提供的医保。
