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Many Older Americans Lost Health Insurance During Pandemic

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What You Need to Know

  • The AARP study found a significant number of Americans aged 50-64 lost health insurance coverage in the first few months of the pandemic.
  • Older-adult unemployment remained at 4.8% as of March 2021, a rate still nearly double pre-pandemic levels.
  • Some Americans in this age group may be uninsured because they are not aware of the options they have, with either ACA plans or Medicaid.

A new study from AARP finds that working Americans ages 50-64 saw significant job loss during the COVID-19 pandemic, and at the same time, many faced the loss of health insurance coverage.

The study, commissioned by the AARP Public Policy Institute and based on analysis from Avalere Health, estimated changes in insurance coverage among adults ages 50 to 64 over the course of 2020 and projected potential changes through December 2022.

It found that a significant number of Americans aged 50-64 lost health insurance coverage in the first few months of the pandemic, and workers this group either remained uninsured or switched to non-group options such as the Affordable Care Act (ACA) marketplaces or Medicaid plans.

Sharp Rise in Unemployment

The pandemic effects on older workers were slightly less dramatic than on younger workers, but there was still a significant rise in unemployment among this group, the study found.

“The unemployment rate among adults ages 50 to 64 jumped significantly in the initial phase of the pandemic, from 2.5% in February 2020 to a high of 12.5 percent in April 2020, according to the Bureau of Labor Statistics,” the study said. “During that two-month period, 4.2 million older adults lost their jobs.”

The report added that the impact might be greater than what the statistics show — because many older workers may have simply decided to retire during the pandemic, at an earlier age than they would have otherwise. These individuals would not show up in unemployment statistics.

The analysis said that the effect of the pandemic is continuing to be felt among workers in this age group.

“The unemployment rate among adults ages 50 to 64 has been gradually improving after its peak in April 2020. However, older-adult unemployment remained at 4.8% as of March 2021, a rate still nearly double pre-pandemic levels,” the report said. “The economic impact of the pandemic will likely be felt for some time, with Avalere estimating the unemployment rate among adults ages 50 to 64 could be as high as 4.9 percent by the end of 2022.”

How it Affected Health Coverage

Like most Americans, workers in this age range usually get their health insurance plans through their employer. With the loss of employment, these Americans had several options, including remaining uninsured, trying to buy a plan on the ACA markets, or applying for Medicaid. The last choice had some limits — as many states have not expanded Medicaid eligibility, and some workers may not be eligible.

The report calls the non-group market — primarily ACA plans — an important safety net for workers in this age group. Although the trends were showing a decrease in older workers who enrolled in non-group markets in the years prior to the pandemic, those trends reversed as the pandemic set in.

“Between March and August 2020, the number of adults ages 50 to 64 enrolled in the nongroup market grew by an estimated 210,000 people,” the report said.

“Much of this group likely lost employer coverage and enrolled in ACA Marketplace coverage through a special enrollment period (SEP) that allows people to enroll outside of the usual open enrollment period.”

Medicaid, the public health plan offered to people with low levels of income, also grew significantly in enrollment for this group of Americans. The study found that between March and August 2020, approximately 460,000 adults ages 50 to 64 gained coverage through Medicaid plans, which is more than twice the number of older adults transitioning into the non-group market during the same time.

“Avalere predicts that Medicaid enrollment, which has stayed fairly steady since August 2020, will continue to remain elevated, with between 230,000 and 320,000 more expected to be enrolled by December 2022 than would have been expected without the pandemic,” the report said.

The ranks of the uninsured also has grown — the analysis predicted that as many as 140,000 more older adults may be uninsured by December 2022 than would have been without the pandemic, and that the uninsured rate for this age group is likely to grow to 10%, from 9.4%, prior to the pandemic.

The report concluded by saying that some Americans in this age group may be uninsured because they are not aware of the options they have, with either ACA plans or Medicaid. “It will be important for strong outreach, education, and enrollment-assistance efforts to continue in order to help connect the uninsured individuals to affordable coverage,” the report said.