Dive Brief:

• Nearly 27 million people in the U.S. may have lost employer-sponsored insurance due to rampant job losses brought on by the COVID-19 pandemic, according to a new analysis from the Kaiser Family Foundation.
• Between March 1 and May 2, more than 31 million people filed for unemployment insurance. KFF estimates nearly 78 million people live in a family that experienced a job loss in that time, a majority of which (61%) were previously covered by employer-sponsored insurance. Almost 80% of the newly uninsured are eligible for publicly-subsidized coverage
• By January 2021, when unemployment insurance will end for most Americans who have recently filed, the eligibility landscape will shift dramatically. Nearly 17 million people will be eligible for Medicaid and roughly 6 million will be eligible for Affordable Care Act marketplace subsidies if they have not found work by that time. The coverage gap (people who make too much to qualify for Medicaid but not enough to receive subsidies for the exchanges) will increase by 80% to 1.9 million Americans.

Dive Insight:

The novel coronavirus pandemic has led to historic levels of unemployment as businesses across the country cut hours or shut their doors in compliance with stay-at-home orders. Some experts think the unemployment rate, now at 15%, is likely higher than recorded, as some people may not have filed for benefits.

Roughly half of Americans receive health insurance through their jobs, so millions of Americans are losing insurance during the crisis. An estimate from the Robert Wood Johnson Foundation found between 25 million and 43 million people could lose their employer-sponsored insurance in the coming months if job losses continue.

There are some options for the newly unemployed: They can stretch out their employer-sponsored coverage for a period through COBRA or could become eligible for Medicaid or subsidized coverage in the Affordable Care Act exchanges.

Among the newly uninsured, almost half, or 12.7 million, are eligible for Medicaid, and another 8.4 million are eligible for subsidies in the marketplace, KFF found. An estimated 19 million people who would otherwise lose employer-sponsored coverage could retain job-based insurance by switching to a family member's plan, while a very small portion — 1.6 million — had another source of insurance, like Medicare, they can keep.

About 5.7 million people who lose coverage through their job are not eligible for any sort of subsidized coverage: 3.7 million whose family income is above eligibility limits, 1.3 million with insurance through another working family member, 530,000 who don't meet citizenship or immigration requirements and 150,000 who fall into the coverage gap.

States with the highest rate of job losses will see the brunt of insurance loss. Eight states — California, Texas, Pennsylvania, New York, Georgia, Florida, Michigan and Ohio — account for just under half of all people who lose insurance. Three of those — Texas, Georgia and Florida — have not expanded Medicaid and are likely to see more nonelderly adults move into the Medicaid coverage gap by 2021.

"As policymakers consider additional efforts to aid people, expanding outreach and enrollment assistance, which have been reduced dramatically by the Trump Administration, could help people maintain coverage as they lose jobs," KFF researchers wrote.

The Trump administration is currently backing a Republican state-led lawsuit to overthrow the ACA that is pending before the U.S. Supreme Court. President Donald Trump reiterated his support for the case earlier this month, despite the precarious situation poised to decimate years of coverage growth in the U.S.

The president has also urged states to reopen to bolster the economy as what's sure to be a confrontational November presidential election approaches, against the advice of his own public health experts.

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a member of the White House coronavirus task force, testified to a Senate committee that prematurely lifting shelter-in-place guidelines could worsen the state of the pandemic in the fall, when it's likely to resurge.

"There is a real risk you will trigger an outbreak that you're unable to control, that will set you back on the road to trying to get economic recovery," Fauci, who has directed NIAID since 1984, told the Senate Health, Education, Labor and Pensions committee on Tuesday.