Advisory Council Explores COVID-19’s Impact on Commercial Health Insurance Coverage

BHIBlog

No Sudden COVID-Related Loss of Employer-Based Insurance, Research Shows

BHI’s Advisory Council members kicked off their research projects this year and in one COVID-19-focused effort, found that research often adds value through counterintuitive findings.

BHI Advisory Council members Michael Chernew, PhD, of Harvard University and Vivian Ho, PhD, of Rice University have been looking specifically at COVID’s impact on Blue health insurance disenrollment rates and how the pandemic has affected our commercial health insurance risk pools.

Experts predict COVID-related drop in health coverage

Several well-publicized studies early this year sought to frame the issue. For example, the Kaiser Family Foundation estimated that nearly 27 million people could lose employer-sponsored insurance due to COVID-caused layoffs. Similarly, Chernew and Ho hypothesized that layoffs would cause higher hea disenrollment rates among the younger and healthier populations, thus negatively impacting the risk pool.

To test this hypothesis, researchers are sampling two populations. The control cohort is a national group of Blue Cross Blue Shield members who were continuously enrolled in 2018 and who disenrolled in 2019. The comparison group is members who were enrolled throughout 2019 and disenrolled in 2020. The HCC risk model developed under the ACA was the primary measure used to understand risk pool changes.


Blue health plan disenrollment trends 2018 and 2019

Data analysis shows no sudden loss of employer-based health insurance

In partnership with BHI, Chernew and Ho observed no sudden acceleration in loss of coverage at the beginning of the pandemic and throughout the summer.

These findings were consistent with a survey of BCBS medical directors and network managers as well as with data from the Bureau of Labor Statistics. Each group found that many job status changes were due to temporary layoffs or furloughs in the first several months of the year and did not necessarily include a loss of healthcare coverage.

Although COVID-19 initially had no impact on coverage, September’s disenrollment rates began to exceed 2019 rates for the first time. This was seen more in ZIP codes with high percentages of minority populations. While risk-level trends in the Blue member population remained relatively steady in September, BHI is continuing to monitor these trends and looks forward to sharing full 2020 data and any other findings in the Spring.