A Pandemic Nudge for Better Access to Care

The Open DoorWe are close to reaching a million deaths from COVID in the U.S. Worldwide, the number passed six million a month ago and that number is a gross underestimate. So there can be no doubt that the pandemic has had a terrible effect on health everywhere. But in the midst of this tragedy, we can find one tiny bright spot. The pandemic has given health policy a nudge toward better access to care in the U.S. than we have ever seen before.

More people in the U.S. have health insurance than ever before. The percentage of Americans without health insurance fell to a record low in the third quarter of 2021 – 8.9 percent.

U.S. Uninsured Rate 2021

More Coverage Despite Disparities

There’s nothing like a crisis to clear away the clutter and sharpen our focus.

Before the pandemic, the uninsured rate was rising in America. One million people lost their health insurance in 2019. At that point, there was lots of talk around efforts to get rid of the Affordable Care Act, which had served to boost the number of people with health insurance.

But with the pandemic, all the petty political bickering about health insurance evaporated. (We found other stupid arguments to have.) With an existential health threat, the conversation moved toward making sure that fewer people died. So Medicaid got a funding boost to keep people from losing their coverage. Vaccines and testing were free. Even uninsured patients got coverage for COVID-19 treatment early in the pandemic.

In short, the pandemic showed how possible it was to improve on the lousy U.S. track record for access to decent medical care. Of course, disparities persisted, but progress was visible.

Job Done?

Thus we know that better access to care is possible. But where we go from here is an open question. Right now, a lot of the expanded access to care that came with the pandemic is set to expire. The program that covered uninsured COVID care is shutting down. Millions of people are at risk for losing Medicaid coverage as pandemic funding expires.

And all of this happens in the context of inequitable access to care that persists. It’s especially galling to us that obesity care is carved out of many public and private healthcare plans. Untreated obesity is part of what made Americans more vulnerable to COVID than citizens of many other countries.

So yes, U.S. policymakers have proven that better access to care is possible. But right now, they’re poised to take us back to the bad old days.

Click here and here for more coverage and access to care, here for more on the spike in uninsured rates that may soon come.

The Open Door, painting by Leon Spilliaert / WikiArt

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April 5, 2022