9.2 million workers likely lost their employer-provided health insurance in the past four weeks

by nyljaouadi1
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We estimate that 9.2 million workers were at high risk of losing their employer-provided health insurance in the past four weeks. To avoid prohibitively costly insurance options, the federal government should fund an expansion of Medicare and Medicaid to all those suffering job losses during the pandemic period.

Two weeks ago, when the two-week total of unemployment insurance (UI) initial claims was 8.7 million, we estimated that 3.5 million workers may have lost their health insurance at work. Since then, 11.4 million more workers filed claims for unemployment benefits, bringing the total of UI initial claims over the last four weeks to 20.1 million, currently the most comprehensive measure of the extent of job losses and furloughs due to the COVID-19 pandemic.

We estimate that across all industries where workers have filed UI claims, about 45.7%of workers had their own health insurance provided through their employer. As a result, of the 20.1 million workers who filed initial UI claims in the last four weeks, 9.2 million may have lost coverage through their own employer-provided health insurance (EPHI).

The analysis, described below, combines industry-specific UI claims data for 11 states, representing about 20% of national employment, with national, industry-specific health insurance coverage rates. Using these data, we provide a rough prediction of 9.2 million workers losing EPHI. We can’t say exactly how many people will lose insurance coverage altogether for several reasons. For example, some workers who lose EPHI due to layoffs or hours reductions that trigger UI claims may be able to obtain coverage through health care exchanges set up by the Affordable Care Act (ACA) or through Medicaid. Some of this group may also be able to obtain continuing coverage through COBRA, paying out of pocket the full cost of their EPHI coverage. Some workers may be able to obtain coverage through other family members, or if only experiencing a temporary furlough or hours reduction, their employers might continue to pay for coverage. On the other hand, our calculations might understate the loss of health insurance coverage because they do not account for family members who are no longer covered because of the policyholder’s layoff. And because not all layoffs result in UI claims, we will underestimate the actual magnitude of job losses.

Because the United States is unique among rich countries in tying health insurance benefits to employment many of the newly unemployed will suddenly face prohibitively costly insurance options. A comprehensive policy solution would be to extend Medicare and Medicaid to all those suffering job losses during the pandemic period, with the federal government funding this expansion. Current discussions suggest there may be legislation that the federal government pay for all of COBRA coverage so that workers who are laid off or furloughed may continue their employer-provided coverage. While this policy proposal will help many workers continue coverage, in some states it will not help workers from small businesses with fewer than 20 employees, who are not eligible for COBRA.

The linkage between specific jobs and the availability of health insurance is a prime source of inefficiency and inequity in the U.S. health system. It is especially terrifying for workers to lose their health insurance as a result of, and during, an ongoing pandemic.

Methodology

Our methodology builds on our previous work, which extrapolated from industry-level statistics published by Washington state. In this updated analysis, we instead use recently collected industry-level UI claims data from 11 states. From these states’ data, we calculate the average industry-specific shock as the number of UI claims as a share of 2019Q3 employment from the QCEW. We apply this industry-specific job loss share to all the other states’ industry-specific employment totals, and then proportionally scale these losses so that each state’s total job loss equals its statewide not-seasonally-adjusted total initial UI claims for the four weeks ending March 21 through April 11. The estimates in the first column of Table 1 are the sum of these industry- and state-specific job losses.

New UI claims and employer-provided health insurance losses for the four weeks ending March 21 through April 11, by industry

Industry Total job losses (UI initial claims) Share of workers with EPHI EPHI job losses Total job losses as a share of industry employment
Accommodation and Food Services 4,061,877 23.9% 969,191 28.1%
Admin. and Support, Waste Mgmt. and Remediation Services 1,606,809 39.1% 628,737 16.8%
Agriculture, Forestry, Fishing, and Hunting 56,283 29.4% 16,531 4.1%
Arts, Entertainment, and Recreation 652,006 37.4% 243,979 22.4%
Construction 1,868,565 44.5% 830,902 23.9%
Educational Services 436,287 61.6% 268,775 3.8%
Finance and Insurance 119,930 70.5% 84,550 2.0%
Health Care and Social Assistance 2,221,493 56.8% 1,261,599 10.0%
Information 231,365 61.9% 143,143 7.7%
Management of Companies and Enterprises 160,690 63.6% 102,228 6.6%
Manufacturing 2,356,106 69.3% 1,633,349 18.2%
Mining, Quarrying, and Oil and Gas Extraction 63,700 74.7% 47,556 9.4%
Other Services (except Public Administration) 1,114,934 33.3% 371,830 24.1%
Professional, Scientific, and Technical Services 746,743 61.0% 455,539 7.7%
Public Administration 127,957 70.4% 90,118 1.7%
Real Estate and Rental and Leasing 280,322 46.5% 130,399 11.9%
Retail Trade 2,529,770 40.8% 1,031,776 16.1%
Transportation and Warehousing 762,437 58.5% 445,827 12.0%
Utilities 12,155 77.1% 9,372 1.5%
Wholesale Trade 709,777 61.5% 436,298 12.0%
All industries 20,119,205 45.7% 9,201,700 13.6%

Source: Authors’ analysis of state-level unemployment insurance (UI) claims, U.S. Department of Labor UI Claims, Quarterly Census of Employment and Wages data, and the 2018 Annual Social and Economic Supplement to the Current Population Survey.

The second column provides national industry-specific shares of employer-provided health insurance coverage rates using data from the 2018 March Current Population Survey, limiting the sample to those who worked in the private sector or government during the previous year. Multiplying the first and second column is our estimate of EPHI job losses: the number of layoffs or furloughs that, on average, workers will be at risk of losing their own employer-based health insurance. Finally, the fourth column expresses the total job loss estimate as a share of 2019Q3 industry-specific employment.

Figure A uses the same methodology but provides state-specific estimates of these job losses.

We should note that other analysis has shown that it is difficult to draw reliable inferences from the industry composition of UI claims. In the case of EPHI, we don’t yet have independent direct data sources on coverage to provide a check for the industry-based estimates in this post. As these sources become available, we will use them to check or supplement these estimates.

Estimated new UI claims and employer-provided health insurance losses for the weeks ending March 21 through April 11, by state

State Total job losses (UI initial claims) EPHI job losses Total job losses as a share of industry employment
Alabama 289,694 137,658 14.6%
Alaska 48,963 22,036 14.5%
Arizona 348,500 155,376 12.2%
Arkansas 133,752 64,183 11.2%
California 2,824,438 1,283,894 16.0%
Colorado 233,011 104,018 8.5%
Connecticut 125,753 58,472 7.6%
Delaware 62,036 27,368 13.9%
Washington D.C. 55,564 22,970 7.3%
Florida 653,975 281,534 7.5%
Georgia 853,618 396,626 19.0%
Hawaii 145,207 58,403 22.7%
Idaho 95,248 42,960 12.5%
Illinois 634,625 293,273 10.6%
Indiana 444,123 214,639 14.5%
Iowa 207,468 99,058 13.4%
Kansas 157,968 75,284 11.5%
Kentucky 395,510 187,080 21.0%
Louisiana 350,504 156,529 18.5%
Maine 89,412 39,724 14.2%
Maryland 298,610 132,708 11.1%
Massachusetts 572,562 258,907 15.8%
Michigan 1,040,215 493,504 23.9%
Minnesota 424,762 198,236 14.6%
Mississippi 129,546 60,537 11.5%
Missouri 333,780 154,427 12.0%
Montana 70,793 30,072 14.9%
Nebraska 83,870 39,198 8.5%
Nevada 303,705 116,248 21.7%
New Hampshire 123,895 56,057 18.6%
New Jersey 677,504 308,437 16.9%
New Mexico 91,580 39,771 11.0%
New York 1,186,994 539,086 12.6%
North Carolina 541,584 247,849 12.1%
North Dakota 42,983 20,133 10.2%
Ohio 854,006 400,230 15.7%
Oklahoma 179,181 82,332 11.2%
Oregon 191,270 86,633 9.8%
Pennsylvania 1,298,125 601,343 21.9%
Puerto Rico 173,926 79,247 20.1%
Rhode Island 114,695 50,075 23.6%
South Carolina 272,560 123,741 12.8%
South Dakota 22,852 10,585 5.2%
Tennessee 317,535 147,008 10.5%
Texas 1,020,345 465,042 8.1%
Utah 105,433 48,529 7.0%
Vermont 44,369 20,285 14.3%
Virginia 412,866 186,918 10.6%
Virgin Islands 448 177 1.3%
Washington 634,526 290,012 18.1%
West Virginia 47,148 21,621 7.0%
Wisconsin 336,672 162,302 11.6%
Wyoming 21,496 9,367 7.7%

Note: EPHI losses are estimated unemployment insurance ( UI) claims associated with employer-provided health insurance.





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