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An estimated 9.3 million American adults lost health insurance coverage as a result of increased unemployment during the recession of 2007-2009, according to a newly published study by researchers at three universities.
The study, titled "The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession," was published online by the National Bureau of Economic Research. The research (www.nber.org/papers/w17600) was authored by John Cawley, PhD, of Cornell University; Kosali Simon, PhD, of Indiana University; and Asako Moriya, PhD, of Carnegie Mellon University.
Roughly nine times as many Americans lost health insurance coverage in the recession of 2007-2009 as in the previous recession of 2001, the researchers found. In addition, an estimated 4.2 million children under age 18 gained health insurance coverage during the recession, supporting the idea that government health insurance programs work counter-cyclically, as intended as part of the social safety net. As parents lose jobs and income, more children qualify for coverage through Medicaid and state Children's Health Insurance Programs (CHIP).
The study found that men were much more likely than women to lose insurance coverage as a result of increases in the unemployment rate, and the effect was strongest for men who were white, older and well educated. Of adults estimated to have lost coverage, 7.1 million were men, and 2.2 million were women.
An increase in the unemployment rate of 1 percentage point for men was associated with a 1.67 percentage point decrease in the likelihood of being insured.
Even for men who didn't lose their jobs, increases in the unemployment rate were associated with a decreased probability of health insurance coverage. This may be because employers dropped coverage, cut workers' hours to where they no longer qualified for health insurance, or increased employee premium contributions, leading to workers declining the offer of coverage.
For children under 18, a 1 percentage point increase in the unemployment rate is associated with a 1.37 percentage point increase in the likelihood of being insured.
The study concluded with a "thought experiment" examining the impact of the 2010 Patient Protection and Affordable Care Act on the relationship between unemployment and insurance coverage. Because of its expansion of Medicaid coverage for adults, a higher unemployment rate would not have a significant impact on insurance coverage with the law in place, the results implied.
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