Affiliation:
1. Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY
2. Department of Consumer Sciences, College of Human Sciences, Alabama Cooperative Extension System, Auburn University, Auburn, AL
Abstract
Background:
Unemployment associated with the coronavirus disease 2019 (COVID-19) pandemic was linked to financial insecurity and disruptions in access to health care.
Objective:
To explore whether expanded access to Medicaid mitigated the likelihood of health and non-health financial hardship associated with pandemic-linked job loss.
Design:
We estimate linear regression models comparing differences in the levels of outcomes attributable to pandemic-linked joblessness in Medicaid expansion and nonexpansion states.
Observations:
A total of 20,281 adults aged 19–64 were in the 2021 National Financial Capability Study.
Measures:
Our key exposure was job loss, layoffs, and furloughs, attributable to the COVID-19 pandemic. Outcomes under evaluation include indicators of health care access and household financial health.
Results:
Relative to persons reporting pandemic-linked unemployment in nonexpansion states, adults experiencing pandemic-linked job loss in expansion states were less likely to report as uninsured [−6.2 percentage points (PPs); 95% CI: −10.8, −1.6; P < 0.01], having unpaid medical bills (−4.3 PP; 95% CI: −8, −0.6; P < 0.05), having unmet medical needs due to cost (−5.3 PP; 95% CI: −10.1, −0.5; P < 0.05), and having calls from debt collection agencies (−6.9 PP; 95% CI: −10.6, −3.1; P < 0.01). Patterns consistent with Medicaid acting as a safety net for the adverse financial effects of job loss were more pronounced for middle-income households.
Conclusions:
In economic downturns, such as the COVID-19 crisis, Medicaid can help insulate households from diminished health care access and financial distress associated with job loss.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Public Health, Environmental and Occupational Health
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