18.2 million Americans at risk of severe COVID-19 lack adequate insurance, study says
A new analysis reveals that 18.2 million Americans considered at increased risk of coronavirus infection due to underlying health conditions had little or no health insurance at the start of the pandemic.
Among those most likely to suffer from severe COVID-19 while uninsured or underinsured are minorities, people with low incomes and individuals living in rural areas, according to the study published June 10 in the Journal of General Internal Medicine.
The results reveal a grim picture of how nearly 17% of the U.S. population will likely hesitate before seeking the medical care they need if infected with the virus because of cost concerns.
“There’s two epidemics here. There’s COVID-19 itself and then there’s inadequate health coverage that is going to hurt people whether or not they have coronavirus or some other illness, disability or injury,” study co-author Dr. Adam Gaffney, an instructor of medicine at Harvard Medical School, told McClatchy News. “There’s no question that the health inequalities in America, once again, turn to the question of healthcare reform.”
Researchers from Harvard Medical School analyzed the 2018 Behavioral Risk Factor Surveillance System, conducted by the Centers for Disease Control and Prevention, to estimate what the state of Americans looks like today.
The government survey of 437,436 individuals conducted via telephone provides data on health and insurance status for people over the age of 16, residing in the 50 states and the District of Columbia and those who are not inmates or on active duty.
The team weighted survey responses to create estimates reflective of the whole nation, Gaffney said.
Based on CDC guidance, individuals considered at risk of severe COVID-19 were people over 65 years old and “non-elderly adults” with chronic obstructive pulmonary disease, asthma, heart disease, severe obesity, kidney disease, cancer and diabetes, the study said.
Then the researchers studied the individuals’ race, income, urban or rural county of residence, stay-at-home orders in their state and state’s status on Medicaid expansion as of January 2018.
What did the study find?
Hispanics were the most likely to be both at risk of severe infection and be uninsured or underinsured, meaning they have health insurance but have skipped a doctor’s appointment within the last year due to cost, the study revealed.
American Indian/Alaska Natives, those who identified as “other” and Blacks were the next most likely to be disadvantaged during the pandemic.
Asians and whites were the least likely to be at increased risk and have little to no insurance, according to the study’s data.
High-risk people living in rural areas and those who made lower incomes fell in the same category, “consistent with the experience of previous viral respiratory epidemics,” the researchers said.
Individuals at increased risk living in Medicaid non-expansion states, meaning residents must qualify based on more than just household income, had a 52% higher chance of being “inadequately insured relative to those in expansion states,” the study said.
High-risk people living in states that did not issue a stay-at-home order as of March 30 had 23% higher odds on inadequate insurance compared to those in other states.
But these numbers are likely higher today, Gaffney told McClatchy News.
“The reality is that tens of millions of people have lost their job, which means they’re losing their health insurance and income,” he admitted. “Our estimates of uninsurance and underinsurance are likely underestimates.”
The researchers said their findings can support ways to address “inadequacies in coverage for the diagnosis and treatment of COVID-19 and for the consideration of additional policies that could expand coverage during the economic downturn.”
This story was originally published June 18, 2020 at 2:26 PM with the headline "18.2 million Americans at risk of severe COVID-19 lack adequate insurance, study says."
