A Record-Low Uninsured Rate, But For How Long? NewsWire

NewsWire: 9/27/22

• In Q1 2022, the share of Americans without health insurance fell to a record low. But it’s likely this milestone is only temporary, since millions of these people are covered by provisions passed early on the pandemic that are set to expire. (The Washington Post)
• NH: Earlier this year, the share of Americans without health insurance fell to a record low: just 8.0%. In a statement, President Biden hailed this news as a victory.
• But the victory may be short-lived.
• For decades, the rate of uninsured Americans was in the double digits. It began dropping in 2010 after the Affordable Care Act was passed, falling from 16.0% to 9.1% five years later. It then hovered between 9.0% and 10.0% before beginning to fall again in 2020.

• The most recent drop was spurred by two events. Medicaid enrollment increased thanks to a March 2020 pandemic relief bill, which mandated that states could continue to enroll new people in Medicaid but could not kick anyone off the rolls. (Typically, enrollees need to prove their eligibility every year.) And the $1.9T relief package passed the following year significantly increased federal subsidies for ACA plans, making them more affordable. The Biden administration also ramped up outreach encouraging people to enroll.
• Between February 2020 and May 2022 alone, the number of Americans enrolled in Medicaid jumped by +25%. Overall, since 2020, the uninsured rate has dropped -1.1%, or by approximately 5.2M people.
• When these two provisions expire, the uninsured rate is nearly certain to rise again. The Inflation Reduction Act, which was passed in August, extended the increased subsidies through 2025. But the fate of Medicaid’s “continuous enrollment” rule (which ensures no one is dropped from coverage) remains provisional. It will expire once the Biden administration lifts the order declaring Covid-19 a federal health emergency, which has to be renewed every 90 days. The HHS estimates that expiration would result in 15M people losing Medicaid coverage.
• The HHS has declared that it will give a 60-day notice to public health officials when the order expires. Given that the next renewal is set for mid-October, the lack of notice means that the order will be extended through at least January 2023. But Senate Republicans are moving to force a vote to end the order in October or November, citing Biden’s recent declaration that the pandemic is "over."
• This will be the second time that Republicans have tried to end the order. In March, a similar measure passed the Senate along party lines (48-47), but did not get a vote in the Democratic-controlled House. If the Republicans take the House in the midterms, this will change, putting the future of Medicaid through April 2023 in question.