SDoH and COVID-19

Original story posted on: July 22, 2020

New report addresses unemployment and insurance challenges amid COVID-19

Unemployment is a hot topic amid the ongoing COVID-19 pandemic, especially within the context of who has health insurance. A recent report by the Urban Institute and sponsored by the Robert Wood Johnson Foundation yielded concerning trends during what is now becoming referred to as “the COVID-19 recession.” There will be profound impact for anyone who provides health services and/or behavioral healthcare.

For the last three quarters of 2020, a total of 48 million non-elderly individuals are expected to be impacted by furloughs and layoffs, with 10 million losing employee-sponsored health insurance. In addition:  

  • Thirty-five percent of those who experienced job loss in their family during the pandemic previously had insurance through another family member’s job, with an additional 27 percent having insurance through Medicaid or the Children’s Health Insurance Program (CHIP).
  • Roughly 2 percent are Medicare beneficiaries.
  • About 20 percent had insurance tied to their job lost due to COVID-19. Smaller percentages had insurance through the non-group insurance market or other public programs, or were uninsured.
  • About 3.3 million individuals will regain employer-sponsored insurance by being added to a family member’s policy, with:
    • Roughly 2.8 million expected to enroll in Medicaid
    • Roughly 600,000 to enroll in the individual market, mainly via the Patient Protection and Affordable Care Act marketplace (which will hopefully be maintained)  
    • Roughly 7.3 million fewer individuals to  be enrolled in employer-sponsored insurance coverage
    • Another 3.5 million will become uninsured
    • There is expected to be a 10 percent further increase expected by the end of 2020

Temporary provisions available during the public health emergencies for continuous eligibility remain in play. These include those related to increased Medicaid and CHIP enrollment. This provision applies if a state accepts additional federal funding through an increased matching rate for traditional Medicaid eligibility categories under the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security, or CARES, Act. Without this eligibility, people would have disenrolled from Medicaid and CHIP, or been found ineligible and automatically disenrolled.

What’s the ultimate outcome? It would be nice to think that many of these individuals will start to regain employment, and with it, insurance. However, that is NOT the reality for many in this already vulnerable and at-risk population. With increased infection rates, ongoing healthcare needs, plus elevated mental health, addiction, and other treatment concerns, we can expect an increased tally of those in need, with greater financial losses for providers. The report is an informative read and available directly from the Robert Wood Johnson Foundation website,

For this week’s Monitor Mondays Survey, we asked what trends our listeners were experiencing with their patients in the context of insurance status since COVID-19 hit. The survey results can be viewed here.

Programming Note: Ellen Fink-Samnick is a permanent panelist on Monitor Mondays. Listen to her live reporting every Monday at 10 a.m. EST.

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management,  Social Determinants of Health: Case Management’s Next Frontier (with Foreword by Dr. Ronald Hirsch), and End of Life Care for Case Management are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk-Ten-Tuesdays, and member of the Editorial Advisory Boards of Professional Case Management, Case Management Monthly, and RAC Monitor. Ellen also serves as the Lead for Rise Association’s Social Determinants of Health Community.

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