When the COVID-19 pandemic began, many people were concerned that millions of Americans would lose employer-sponsored health insurance coverage and become uninsured. In this study, we analyze data from the National Health Interview Survey, the Current Population Survey, and the Health Reform Monitoring Survey to explore trends in coverage status and type between early 2019 and early 2021. We find that the uninsurance rate among nonelderly adults remained flat between early 2019 and early 2021, and that gains in public coverage offset estimated private coverage losses on all three surveys. Supporting evidence from Medicaid and Marketplace enrollment data further indicate that the health insurance safety net, enhanced by the Families First Coronavirus Response Act, successfully prevented a lasting rise in uninsurance about a year after the pandemic began. But the continuous coverage requirement in Medicaid will expire when the public health emergency ends, and the enhanced Marketplace subsidies established by the American Rescue Plan Act are set to expire at the end of 2022. The Build Back Better Act has the potential to further strengthen the health insurance safety net, but the bill has stalled in the Senate and its future is uncertain. Thus, without additional action, uninsurance rates could begin to rise again in the coming years.
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