COVID-19, Unemployment Compensation, and State Medicaid Expansion Decisions

Brief

COVID-19, Unemployment Compensation, and State Medicaid Expansion Decisions

Some Workers Losing Jobs and Health Insurance Remain Ineligible for Subsidized Coverage

Abstract

In this analysis, we expand upon our earlier work to show how the additional levels of unemployment insurance provided through the Federal Pandemic Unemployment Compensation program affects eligibility for subsidized coverage in expansion and nonexpansion states. We then simulate the effects on eligibility of extending the additional federal unemployment compensation, currently limited to 16 weeks, through the remainder of 2020, as proposed in the ‘‘Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act.’’ We also show the implications of excluding all unemployment compensation from public health insurance eligibility determinations. 

The fact that 15 states have yet to expand eligibility for Medicaid under the ACA complicates federal policy to help workers losing their jobs due to the COVID-19 crisis. It means that federal cash relief provided to unemployed workers will affect these workers’ access to financial assistance for health insurance differently by state. As currently legislated, the additional unemployment compensation provided to workers by the federal government for up to 16 weeks is not counted for purposes of determining Medicaid/CHIP eligibility, but it is counted for purposes of determining marketplace subsidy eligibility. Since many nonexpansion state workers whose incomes fall below the poverty level once unemployed would be eligible for no help whatsoever, the additional federal unemployment compensation lifts some of their income enough to give them access to marketplace subsidies. But that same assistance for expansion state workers can lift their incomes high enough to exceed marketplace subsidy limits.

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