States are key to social security expansion – COVID proves

Job-dependent health coverage can create instability, as highlighted by the crisis created by the COVID-19 pandemic (Collins et al. 2020). Between 2019 and 2021, more than 1.2 million more individuals have obtained health insurance during the special and open enrollment periods through the marketplaces created by the Affordable Care Act. Between March and August, 2020, 5 million other people newly enrolled in Medicaid and CHIP, many after losing their jobs and employer-sponsored health insurance. Prior to the pandemic, a substantial majority of the states had adopted the Affordable Care Act’s Medicaid expansion, making poor adults younger than age 65 whose current incomes are below 138 percent of the poverty line eligible for Medicaid, which almost certainly helped significant numbers of residents of those states remain insured during the crisis. Figure 12 shows Medicaid and CHIP enrollment growth between February and August 2020. Interestingly, of the 13 states that have not implemented the ACA’s Medicaid expansion, four (Florida, Missouri , Utah, and Wyoming) saw increases in Medicaid and CHIP enrollment of over 10 percent in the 6 months following the onset of the pandemic.7 Of the 29.8 million individuals without insurance in 2019, two-thirds were eligible for subsidized health insurance: roughly 20 percent met requirements for Medicaid and CHIP, and roughly 50 percent were eligible for a marketplace subsidy or subsidized employer-sponsored health coverage. Employer-sponsored health coverage is subsidized for many individuals through employer contributions, as well as through arrangements that exclude from taxable income employee premium payments deducted from paychecks