Introduction
The COVID-19 pandemic brought about unprecedented changes in various sectors, including healthcare. One of the significant outcomes of the pandemic was the implementation of policies that aimed to reduce cost-related barriers to healthcare access. A recent report highlights a notable decrease in the number of adults reporting such barriers between 2019 and 2022. This blog delves into the impact of these pandemic-era policies and examines their implications for the future.
Impact of Pandemic-Era Policies
Medicaid’s Continuous Coverage Requirement
During the pandemic, the Families First Coronavirus Response Act provided states with additional Medicaid funding on the condition that they halt Medicaid disenrollments during the public health emergency (PHE). This continuous coverage requirement ensured that millions of Americans maintained their health insurance coverage during a time of heightened uncertainty and need.
Enhanced Marketplace Tax Credits
The American Rescue Plan Act (ARPA) of 2021 played a crucial role in enhancing healthcare access by increasing Marketplace premium tax credits. These credits were extended to individuals with family incomes between 100% and 400% of the federal poverty level and even beyond. This expansion significantly increased the number of people with Marketplace insurance coverage, thereby reducing the financial burden associated with healthcare.
Decline in Cost-Related Barriers to Care
Uninsurance Rates
The pandemic-era policies had a profound impact on uninsurance rates. Data from the National Health Interview Survey (NHIS) showed a decline in the number of uninsured individuals from 14.5% to 12.4% between 2019 and 2022. This reduction translated to millions more Americans having access to essential healthcare services.
Continuous Coverage
Continuous coverage for the entire year increased from 82.1% to 84.4% during the study period. This improvement was more pronounced in states that had expanded Medicaid and among adults with family incomes below 250% of the federal poverty level.
Care Access Improvements
The proportion of adults who reported skipping needed medical care due to cost fell from 12.1% to 9.7%, equating to 4.75 million fewer people facing cost-related barriers to healthcare. This positive trend was particularly notable in states that expanded Medicaid and among individuals with lower family incomes.
Notably, prescription drug access also improved. The number of adults who did not get needed prescriptions due to cost decreased from 9.8% to 7.5%. This improvement highlights the critical role of pandemic-era policies in enhancing medication adherence and overall health outcomes.
Threats to Healthcare Affordability Post-PHE
Medicaid Disenrollments
The end of the PHE on May 11, 2023, marked the discontinuation of many pandemic-era protections. As a result, at least 23,785,000 Medicaid enrollees were disenrolled from the program by June 28, 2024. This massive disenrollment raises concerns about a potential increase in cost-related barriers to care.
Future of Marketplace Subsidies
The potential expiration of enhanced Marketplace subsidies after 2025 poses another significant threat to healthcare affordability. Policymakers and healthcare advocates fear that without these subsidies, the gains in coverage and access achieved during the pandemic may be difficult to sustain.
Conclusion
The pandemic-era policies significantly reduced cost-related barriers to healthcare, resulting in millions more Americans accessing essential medical services. However, the end of these policies poses a risk to the continued affordability and accessibility of healthcare. To build upon the progress made, policymakers must consider extending and expanding these protections to ensure that all Americans have access to affordable, high-quality healthcare.
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FAQs
1. How did pandemic policies reduce cost-related barriers to healthcare?
A. Pandemic policies like Medicaid’s continuous coverage requirement and enhanced Marketplace tax credits ensured that more people maintained their health insurance coverage, reducing the financial burden of healthcare.
2. What was the impact of the Families First Coronavirus Response Act?
A. This act provided states with additional Medicaid funding, requiring them to halt Medicaid disenrollments during the public health emergency, thereby maintaining coverage for millions of Americans.
3. What are the concerns post-PHE?
A. The end of pandemic-era policies has led to significant Medicaid disenrollments and concerns about the potential expiration of enhanced Marketplace subsidies, which could increase cost-related barriers to healthcare.
4. How did the American Rescue Plan Act enhance healthcare access?
A. The ARPA increased Marketplace premium tax credits, extending them to a broader range of income levels, which significantly increased the number of people with Marketplace insurance coverage.
5. What should policymakers do to maintain healthcare affordability?
A. Policymakers should consider extending and expanding pandemic-era protections to ensure continued access to affordable, high-quality healthcare for all Americans.
