The Affordable Care Act (ACA) has provided an invaluable safety net for individuals who lost their jobs during the coronavirus disease 2019 (COVID-19) pandemic, according to a new article published in the New England Journal of Medicine.

The COVID-19 pandemic has caused more than 800,000 deaths and there has been over 23.4 million confirmed cases worldwide, according to the World Health Organization. Due to widespread shutdowns, many individuals have lost their jobs. According to a study conducted by the Brookings Institute, more than 40 million unemployment benefit claims have been filed, which exceeds unemployment levels during the Great Depression.1

The study used data from the US Department of Health and Human Services’ Medical Expenditure Survey. The study compared data on 1350 adults who lost their job prior to 2014, when the ACA’s Medicaid and marketplace provisions were established, and 1103 adults who lost their jobs after 2014.2

The study authors found that between 2011 and 2013, job loss was associated with a 4.6% decrease in coverage. Participants with coverage decreased from 66.3% to 61.7% over the course of the 2 years. After the ACA went into effect, the coverage rate was 76.2%. 

Job loss was no longer linked to an increase in the uninsured rate.2 Medicaid gains (8.9%) and marketplace coverage (2.6%) offset the vast majority of the reduction in employer-sponsored insurance. The study found that the ACA increased the likelihood of having coverage after a job loss by 6%. 

"In the current context of millions of Americans losing their jobs and an ongoing pandemic, overturning the ACA would most likely be devastating to patients, clinicians, hospitals, and state economies…The very virus that has brought about record unemployment levels is the same agent that makes health insurance--and the new options created under the ACA--more important than ever,” the study authors wrote.

Even with the ACA, coverage gaps still exist.The ACA’s constitutionality is currently under review amid a Supreme Court challenge from 18 Republican state attorney generals and the Trump administration. 

Reference:
1. Despard, Mathieu et al.  COVID-19 job and income loss leading to more hunger and financial hardship (Article) Washington, DC July 13, 2020, Brookings, Accessed August 20, 2020

2. Affordable Care Act key to keeping people insured amid COVID 19-related job losses (Press release) Boston, MA, August 19, 2020, EurekAlert! Accessed August 20, 2020