Ranks Of Uninsured In Oregon Grow

A growing number of Oregonians are losing health insurance as the economic slump created by the COVID-19 pandemic persists, but the exact number of people without health coverage is unknown.

A new report by the nonprofit group Families USA estimates that 50,000 Oregon adults ages 19 to 64 lost their health insurance between February and May, swelling the total number of the state’s uninsured to at least 320,000 out of a total population of 4.2 million.

Nationwide, 5.4 million adult workers have become uninsured because of job losses over the same period, a far bigger surge than during the 2008 recession, the Washington-based group said.

As Oregonians have lost their jobs, many have also lost their employer-provided health insurance. The Oregon Health Authority said it hasn’t determined how many people that entails.

“Before COVID-19 happened, 94% of (all) Oregonians had health coverage, and we were looking at strategies for how to close the gap in coverage for the remaining 6%,” said Trilby de Jung, deputy director of health policy and analytics for the OHA. “Due to the economic and health impacts of COVID-19, we will have to shift our work to understanding who has been most impacted by a loss of coverage and how we get back to that high level of health coverage.”

Adults under 65 are the most likely demographic group in Oregon to lack health insurance, compared to, for example, children or seniors. Families USA estimated that 13% of Oregon adults under 65 now lack health insurance, up from 11% before the pandemic. That compares with 29% now in Texas, the group estimated, and 25% in Florida, two states that did not expand Medicaid coverage under the Affordable Care Act and that also have high rates of COVID-19.

The group is advocating for the so-called HEROES Act, a $3.4 trillion bill being pushed by Democrats in Congress to provide sweeping federal aid, including subsidies to help pay premiums so unemployed workers can keep health insurance from their former employers under the COBRA process. But the act is stalled as Democrats, Republicans and President Donald Trump argue over the cost and scope of aid. The sides cannot agree on whether to issue new stimulus checks or how much weekly cash to give the unemployed, let alone how to make sure millions of Americans keep health insurance.

An estimated 175,000 Oregonians have lost their jobs since the onset of the pandemic in late February, pushing the state’s jobless total to 243,000 as of the latest tally, for June.

Many of those who have lost employer-provided insurance have signed up for the state’s no-cost Medicaid program for low-income people, the Oregon Health Plan. Since the onset of the pandemic, Oregon’s Medicaid enrollment had swollen to 1.17 million people by late July, up roughly by 90,000 residents since early March.

Other laid-off people who may qualify for the Oregon Health Plan have failed to apply, said Stan Dorn, author of the Families USA study and director of the nonprofit’s National Center for Coverage Innovation.

“Job loss is traumatizing for many of us. Research reports high rates of anxiety, depression and grief,” Dorn told The Lund Report. “People who just lost their jobs tend to be focused on core survival: qualifying for unemployment insurance and (food stamps), making sure the rent gets paid, the lights stay on and the family has enough food to eat. Unless someone in the family has an urgent health care need, many lack the bandwidth to learn about health coverage programs and complete the necessary paperwork.”

Plus, some laid-off people may be financially ineligible for Medicaid because their spouse works or they have other income, Dorn said.

The state tracks uninsured rates every two years through a sample survey of Oregonians about their health care coverage. The next one is slated for 2021. Last year’s survey found that 243,600 Oregoninans through age 64 lacked insurance. Experts have estimated that about 130,000 undocumented immigrants in Oregon are not insured.

Dorn said solid numbers on how the pandemic is swelling the ranks of people without health insurance are difficult to nail down.

The Families USA’s analysis is based on estimates of the number of unemployed who are likely to become uninsured, based on past (insurance) coverage patterns. 

“They are not precise counts of uninsured,” he said.

The study looked at state-by-state Census data for the uninsured in 2018, and at unemployment data for February through May of this year. It then estimated how the layoffs this year affected the tally. Oregon, a so-called Medicaid expansion state under the Affordable Care Act, raised the income cutoff to qualify for the Oregon Health Plan in 2014.

The analysts estimated that in Oregon an adult worker who lost their job had a 22% chance of also being without health insurance, Dorn said. The others might sign up for the Oregon Health Plan, go on their spouse’s insurance or buy insurance on the commercial market.

Legally, Oregon can grant Medicaid to anyone who receives unemployment insurance and who vouches that their income is under the Medicaid cutoff levels, he noted.

Under the Families First Coronavirus Response Act, a federal law passed in March that provides increased Medicaid money to states, Oregon says it is not verifying income levels claimed by Medicaid applicants. The state is relying on the applicant’s honesty. That nonverification system will stay in place until the act and the special funding lapse, on Dec. 31.

Nationwide, some noncitizens seeking permanent U.S. residency have been reluctant to apply for Medicaid for fear the federal government would count that against them in their residency application. The Trump administration had said it would consider Medicaid usage as evidence the applicant was a “public charge,” that is, dependent on public services. But a federal judge late last month struck down that rule for as long as the COVID-19 crisis lasts.

De Jung, the OHA official, said the COVID crisis underscores the importance of health insurance.

We “know that Latinx, Black and American Indian and Alaska Native communities already had higher uninsured rates than the state average (prior to the pandemic) and are being disproportionately impacted by COVID-19. We are prioritizing work to address those disparities,” de Jung said.

She also said people who need Oregon Health Plan coverage will increase the longer the economic downturn continues.

The state estimates that for the time being it is receiving enough extra Medicaid money under the Families first Coronavirus Response Act to cover the increase in people on the Oregon Health Plan. Each additional person on the plan costs the state $6,000 to $8,000 to insure.

You can reach Christian Wihtol at [email protected].

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