In the context of unprecedented job loss due to COVID-19, much attention has rightly been paid to the surge in unemployment insurance claims. In Kentucky, unemployment claims have been stacking up since the necessary stay-at-home orders and business and school closures in late March, and now stand at almost 500,000 claims. An important consequence of rising unemployment is that because many Kentuckians have health insurance through their employers, approximately 228,300 Kentuckians have likely also lost their health care coverage.
A recent analysis by the Economic Policy Institute estimates 45.7% of Kentuckians who have lost their jobs in the last several weeks have also lost their health coverage amidst the public health crisis. Based on the notably large number of initial unemployment claims in Kentucky, that means approximately 228,300 are newly uninsured, a number expected to increase as job losses continue to climb. There were already 223,000 Kentuckians without health insurance prior to the COVID-19 pandemic.
Many of these uninsured and unemployed Kentuckians will qualify for Medicaid, at least temporarily. The Kentucky Cabinet for Health and Family Services (CHFS) has already taken steps to simplify Medicaid enrollment and eligibility for newly uninsured Kentuckians. Instead of the 20-page application typically required to apply for Medicaid, all Kentuckians who are uninsured and under 65 can complete a shorter application and receive health coverage under what is known as “presumptive eligibility” through June 30. Since March 1, over 83,000 Kentuckians who were previously uninsured either before or because of COVID-19 have now been covered under presumptive eligibility.
Beyond the temporary coverage of presumptive eligibility, for those who are seeking other forms of coverage, application assisters can help navigate options including the individual insurance marketplace, traditional and expanded Medicaid coverage or the Kentucky Children’s Health Insurance Program. Additionally, some Kentuckians can keep their employer-sponsored insurance through COBRA, but this option is typically much more expensive than marketplace coverage and certainly than Medicaid, which doesn’t charge premiums or co-pays. Those looking for additional resources to apply for Medicaid can utilize Kentucky Voices for Health’s resource page.
Kentucky should continue to exercise all flexibilities within Medicaid to ensure Kentuckians suffering from lost employment and income can easily obtain coverage. But the state has only so many tools at its disposal. In order to ensure as many Kentuckians are covered as possible, the federal government should take steps to fully fund coverage for those who lose employer-provided health insurance due to COVID-19.
Policies that could do that include funding COBRA for all who have lost their jobs during COVID-19, extending and paying for presumptive eligibility under Medicaid, and/or increasing premium tax credits to fully cover insurance on the exchange. Additionally, to allow the state to protect coverage under Medicaid, Congress needs to further increase its share of traditional Medicaid spending beyond the 6.2 percentage points in the Families First Coronavirus Response Act, provide that higher match until the economy fully recovers, and include expanded Medicaid in the boost.
