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Health Coverage in an Economic Downturn: Impact of Tight Budgets on Families and States

The economic downturn has strained family finances and prompted some Americans to cut back on medications and forgo preventive care and visits to the doctor. At the same time, the downturn has triggered declines in tax revenue that inhibit states’ ability to meet rising Medicaid program costs as enrollment spikes during economic hard times. Many states are expected to struggle to close budget gaps despite moves by Congress and the Obama Administration to temporarily boost federal matching money for state Medicaid programs.

The Foundation has created a number of resources that shed light on how Americans and states are faring and provide background on the uninsured, employer-sponsored health insurance costs, trends in states’ Medicaid enrollment and spending and prior efforts to shore up the Medicaid program during a slumping economy.

Public Opinion: Kaiser Tracking Polls

  • The March Health Tracking Poll finds that 57 percent of all adults say they have put off some sort of needed medical care over the past 12 months because of costs, and one third say they or someone in their household has had problems paying medical bills over the past year.

Family Budgets, Health Coverage and Unemployment

  • Impact of Unemployment: A one percent rise in the nation’s unemployment rate is projected to increase the number of uninsured by 1.1 million people. kaiserslidesicon.gifSee the chart.

  • Changes in Health Insurance Coverage, 2007–2008: Early Impact of the Recession
    This issue brief examines trends in health insurance coverage from 2007 to 2008, a period marked by the start of a deep recession. It finds that the share of the nonelderly population covered by employer-provided insurance declined, the share covered by public programs increased and the number of uninsured people continued to rise. The downturn affected coverage for adults differently that it affected coverage for children.

Implications for States and People on Medicaid and SCHIP

  • The Role of Medicaid in State Economies
    This new analysis of 29 studies in 23 states examines the economic stimulus derived from Medicaid spending, and the adverse effects of Medicaid spending cuts.

Employer-Sponsored Health Insurance Costs

  • 2009 Kaiser/HRET Employer Health Benefits Survey
    This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including changes in premiums, employee contributions, cost-sharing provisions, and other relevant information.

State Data

Statehealthfacts.org has extensive state-specific data illustrating the effects of a downturn.

The Uninsured

  • The Uninsured: A Primer
    This primer reviews the basic profile of the uninsured population, how they receive care, the latest trends in health insurance coverage, and what the options are for increasing coverage.

  • Five Basic Facts on the Uninsured
    This brief provides basic facts that explain why so many people lack coverage and how being uninsured affects their health and financial security.