Losing health insurance after a job loss: 5 alternatives to employer-based coverage

The massive scale of job losses associated with the coronavirus pandemic has been nothing short of horrifying. And for millions of Americans and their families, the loss of their employer-based health insurance will be equally horrifying—especially because it comes at a time when families need it most.

According to a recent estimate from the Kaiser Family Foundation, more than 26 million people will become uninsured as a result of the recent COVID-19 job losses. California, Texas, Pennsylvania, New York, Georgia, Florida, Michigan, and Ohio will be the hardest hit in terms of sheer numbers, with those states combined accounting for almost half of the newly unemployed, KFF estimates.

Fortunately, the majority of newly uninsured families will qualify for coverage under the Affordable Care Act and other alternatives. In a separate analysis, KFF lists five distinct options:

Medicaid: Many states have expanded Medicaid benefits under the ACA (full up-to-date list here), and people whose income falls below the threshold could qualify.
Marketplace: The general ACA marketplace is available for people who don’t qualify for Medicaid, and families below certain income thresholds may be eligible for subsidies.
ESI dependent coverage: People who lose their jobs may be able to get covered through their spouse’s or parent’s employer-sponsored insurance (ESI) as a dependent.
COBRA: This temporary option is available to many workers who lose their jobs, although it isn’t cheap.
Short-term plans: According to KFF, short-term plans of up to a year “can sometimes be renewed under revised rules from the Trump administration.”

KFF’s full analysis—along with a detailed breakdown of the above options—can be found on its website.

The sudden and dramatic rise in unemployment is causing some long-time vocal critics of the Affordable Care Act, aka Obamacare, to see the landmark health law in a new light. In a recent interview with PBS, Republican Senator John Cornyn of Texas—who fought for years to repeal the law—said it was “good news” that many people who lose their employer-based healthcare have the ACA as an option. (We’re glad that’s cleared up.)

Tragically, not all newly uninsured people will be eligible for alternative coverage, according to KFF, which estimates that 5.7 million Americans could be left with the additional burden of paying for full coverage. The reality is, many are likely to remain uninsured.