How many Americans are uninsured during the pandemic? Not as many as you may think

The share of people with private health-care plans fell only 2%.


For many Americans, November marks the start of open enrollment season when they pick a new health plan through their employer or through the Affordable Care Act marketplaces. Given the number of people who became unemployed, and potentially uninsured, during the pandemic, you might assume that this year's insurance enrollment season will be more important than ever: One early projection estimated that 5.4 million laid-off workers lost their health insurance between February and May.

However, despite those initially dire projections — particularly those about people who lost their health insurance — recent data from the Census Bureau's experimental Pulse Survey indicates that the share of uninsured Americans aged 18 to 64 has remained relatively flat throughout 2020.

Census Bureau data is the gold standard for monitoring population trends in the U.S., and the bureau usually releases its findings on a one-year lag. This year, however, the Census Bureau designed the Pulse Survey to measure Covid-19's impact on everyday life, and it began releasing those results in (somewhat) real time.

Grow's analysis of the survey's first phase, which ran from the end of April through the middle of July, found that percent of uninsured Americans rose by less than 1%.

The fluctuation between those who had privately or publicly sponsored insurance plans was also minimal. The share of people with private health-care plans fell 2%, while the share of people with government-backed insurance rose 2%. One way of looking at that shift: People who lost their employer-sponsored coverage likely picked up a new policy on one of the exchanges.

Results from the survey's second phase, which began in late August and is still collecting data, show even smaller fluctuations in people's insurance status.

Why the data may not give a complete picture

Though the Pulse Survey's results look promising, Jessica Banthin, a senior fellow at the Urban Institute, cautions that they don't show the full picture. It's important to not only look at the responses but also look at the set of people who either didn't know their insurance status or didn't answer the insurance question at all, she says.

In the survey's first phase, between 10% and 15% of respondents consistently said they didn't know their insurance status or ignored the question altogether. In the second phase, that number has consistently been higher than 20%.

"People have a hard time answering questions about insurance coverage. It's just one of those difficult questions," Banthin says. People often know they have health-care coverage, but they don't know the specifics of their kind of coverage, she explains. For example, people often confuse Medicare and Medicaid.

People have a hard time answering questions about insurance coverage. It's just one of those difficult questions.
Jessica Banthin
Senior fellow, Urban Institute

Adding to the confusion is the way in which people have become unemployed — and subsequently uninsured — during the pandemic.

"Some employers were continuing to pay for their furloughed employees' health insurance coverage," Banthin says. But many of those workers have now gone from furlough to permanent unemployment, "so they no longer have their insurance." 

Covid's effect on the uninsured rate will be easier to measure after open enrollment

When the Affordable Care Act became law in 2010, more than 21% of Americans between the ages of 18 and 64 didn't have insurance, according to Grow's analysis of Census Bureau data. Last year, that number was less than 13%.

Experts say the comprehensive picture of the health insurance landscape this year will likely come after enrollment on the federal marketplace closes on December 15.

Data from earlier this year shows that more people are seeking government sponsored health care, indicating that they have lost their privately sponsored plans. The Centers for Medicare & Medicaid Services recently reported a 7% increase in Medicaid enrollment between March and July of this year.

If you have recently lost your job, you may have several options for obtaining new health insurance coverage, including joining a family member's plan, extending your previous coverage under COBRA, or buying a new plan on the ACA marketplace. Compare your options carefully to see which is the best fit.