We’re in the middle of a health-care crisis, and not just because of COVID-19’s viral biology. The pandemic has caused a recession, and in the U.S., where health-care coverage is linked to employment, all recessions are health-care crises, too. Around 5.4 million people lost health insurance from February to May of this year, the New York Times reported earlier this month, a figure that outpaces insurance losses during the worst months of the recession in 2008. The bleeding isn’t stopping, either. Over 1.43 million people filed jobless claims last week, and in Congress, both parties are far apart on a new economic rescue package.
Workers without health insurance have a few options of varying quality. They can shell out for COBRA, which can run families over $1,000 a month, or shop for a new plan on the Affordable Care Act’s marketplace exchanges, or apply for Medicaid, an easier process in states that have expanded the program. According to a new poll, many physicians see that last option as a way to help people who are now desperate for health care. On the 55th anniversary of its creation, Medicaid is still a lifesaver.
Sixty-three percent of doctors surveyed by Data for Progress and the Committee to Protect Medicare agree that Medicaid should cover the unemployed by default. Among doctors who identify as Democrats, the figure is even higher: 87 percent support the idea, as compared to 63 percent of Independents and 41 percent of Republicans. In states that haven’t expanded Medicaid, doctors are slightly more likely to say expansion should cover the unemployed. Sixty-eight percent support it, though there’s a significant partisan discrepancy; 93 percent of Democrats want expansion and only 39 percent of Republicans agree.
“As physicians who are on the frontlines of the fight against COVID-19, we urge policymakers in Washington to do everything in their power to provide healthcare to millions of people who are out of work and help save countless lives,” Dr. Rob Davison, the executive director of the Committee to Protect Medicare, told Intelligencer in a statement. Noting that an overall “plurality” of Republicans backed expansion for the unemployed, he added, “Regardless of our political affiliations, physicians agree by an overwhelming margin that we face a national emergency and that failure to provide health care to those who don’t have it, in the middle of a deadly and highly contagious pandemic, will put lives at risk.”
Medicaid expansion tends to be popular with voters. Five states have now passed expansion by referendum, with Missouri set to maybe become the sixth next week. Eligibility criteria varies from state to state, which can still leave some vulnerable populations without access to health-care coverage. In general, though, expansion is tied to positive health outcomes. According to a recent study published by Vanderbilt and Harvard Medical School researchers, expansion states reported smaller declines in physical and mental health, compared to states that still haven’t expanded the program.
Expanding Medicaid may help save lives. But the pandemic didn’t create a crisis out of nothing. Health inequity is an old problem that requires transformative long-term solutions. On that subject, though, doctors appear more divided. Only 20 percent total backed Medicare for All; an equal number supported a public option. Forty-one percent say they’d prefer unspecified changes to the Affordable Care Act. That may place physicians to the right of the American electorate, which warmed toward Medicare for All as the pandemic progressed. In April, a Morning Consult poll found that 55 percent of voters now support the policy, as championed by national figures like Senator Bernie Sanders of Vermont. Support is highest among Democrats, 59 percent of whom said they supported Medicare for All.
But in the absence of a more universal solution, making sure Medicaid covers the unemployed looks like a pandemic necessity.