The COVID-19 recession and healthcare coverage in the U.S.

COVID-19 continues to disrupt healthcare, and the economic shockwaves of the pandemic have led to record unemployment and scrambled the mix of who provides health insurance for which people. The changing composition of U.S. health insurance markets is closely linked to the trajectory of the U.S. economy and the pandemic itself, and the potential range of outcomes depends on numerous factors ranging from Medicaid eligibility requirements by state, the size and population health characteristics of each state’s insurance markets, and the behavior of consumers and governments alike. Milliman developed the COVID-19 Advanced Population Shift (CAPS) Model to analyze these dynamics, modeling transitions between sources of coverage and projecting changes in the size and composition of health insurance markets as people exit the employer-sponsored system and turn to Medicaid, the ACA individual market—or go uninsured. This report summarizes our findings.