The Insurance ImbalanceHow COVID-19 is Reshaping Access to Coverage – and Care
November 20, 2020
The pandemic’s effects are personal. They are long-lasting. They are multi-dimensional, impacting people physically, mentally, emotionally and financially. And no one is immune.
In April, during the first wave of the pandemic, a close family member lost his job, and with it his employer-based health insurance. With a family reliant on his plan, regaining coverage was paramount. The high cost of COBRA prohibited him from continuing with private insurance, so, for the first time in his life, he must rely on government programs to ensure his family is covered.
Clearly, my family member is not alone. A recent G&S snap poll found that 18% of Americans lost employer-based health insurance as a result of the pandemic. Over a quarter (26%) of those who lost coverage through their employer say they are now reliant on Medicaid, while another 12% do not currently have any health insurance.
Loss of Coverage: We All Lose
The Economic Policy Institute released a report in late August estimating that 6.2 million workers already had lost access to health insurance that they previously received through their employer due to COVID-19. Public health insurance options are expanding to absorb these coverage losses, but they have not yet expanded enough to include everyone in this large group of people who suddenly lost coverage during a particularly critical time.
Stan Dorn, Director of the National Center for Coverage Innovation at Families USA, recently told The New York Times that he believes we are on track to witness the largest coverage losses in our history. The same article projects that, by the end of this year, tens of millions of Americans could lose their employer-based insurance. What happens next is critical. How will the insurance industry adapt to the precipitous drop in insured lives? Will the Health Insurance Marketplace expand to offer more people affordable coverage?
Innovations and Alternatives: Expediting Access to Care
Innovative approaches that address coverage losses can be found in the private sector. Sesame, a direct-to-patient healthcare company, offers access to quality care at affordable prices – no insurance needed. From primary care and prescription refills to dermatology and mental health care, patients pay one fee per visit with no surprise billing after the appointment.
Direct Primary Care has gained popularity as another alternative to accessing healthcare services without having to utilize traditional insurance. Under these programs, patients often pay a flat monthly or yearly fee in exchange for direct access to their clinician and a broad range of primary care services. The goal is to position insurance as it was originally intended: as a safeguard against accidents and serious illness. According to Direct Primary Care Frontier, there are approximately 790 Direct Primary Care practices in the U.S.
The Bottom Line: Communication Is the Key
When someone loses a job, they have multiple options to continue insurance coverage. Yet there is a prevailing lack of visibility to these solutions. In the case of my family member, he was informed by his employer of his COBRA option – and then he was on his own. He did not know about companies like Sesame, nor did he have any resources to research government options or the alternatives available on the Marketplace.
There is a clear disconnect between the insurance information an employer provides at termination and what that employee really needs to know to properly manage their insurance continuity options. With 55% of the population relying on employer-based health insurance, this communications challenge needs a solution – and fast.
We know that consumers demand simple, direct, clear communications in every aspect of their lives. Healthcare should be no different. While buying health insurance is much more complicated than buying a car, it is critical for the industry to adapt and meet consumers where they are now, acknowledging that this might look very different prior to the pandemic.
The G&S Snap Poll found that consumers are 15% more likely to communicate with their provider via an app after COVID-19 than they were before the pandemic. Increasingly, healthcare is being consumed in an online, virtual, in-real-time manner, whether by scheduling appointments via app or accessing lab results via online portal. Urgent-care center and COVID-19 testing leader CityMD, for instance, now provides email reports of rapid testing results to patients within an hour of their visit. Insurers, employers and other providers need to note this digital shift and alter their patient communications tactics appropriately.
There is no doubt that COVID-19 has reshaped the way we access, deliver and, ultimately, pay for care. Clear communication from all players in an already complex ecosystem has become more important than ever, especially when it comes to educating consumers about their insurance options at the critical point when their coverage suddenly changes – or lapses. Our system works best when more of our population has access to quality care. As communicators, let’s use this opportunity to rethink how we communicate to our employees and patients to ensure the best possible outcomes for everyone.
This G&S Snap Poll was administered online in October 2020 to a representative U.S. sample of 1,041 adults aged 18. The sample has been balanced for age and gender based on the Census Bureau’s American Community survey to reflect the demographic composition of the U.S.