Potential Impact of Stay-at-Home Orders on Health Insurance Rates

Most Americans receive health insurance through their job or a family member’s job. So, when workers lose their jobs, they — and their family members — run the risk of losing their health coverage as well.

Previously released estimates from the U.S. Census Bureau’s Current Population Survey Annual Social and Economic Supplement (CPS ASEC) show that about 55.1% of the U.S. population — some 178 million people — had employer-sponsored insurance or ESI in 2018.

A more detailed portrait of ESI gives us a glimpse at those who may be at risk of losing their health insurance in light of recent economic upheaval due to COVID-19.

Workers in Key Occupations

Recent economic shifts have likely affected workers in certain jobs more than in others. Media coverage has heavily focused on workers in food service and retail occupations who have lost jobs due to social distancing measures and the closing of non-essential businesses in many states.

According to the Bureau of Labor Statistics, the unemployment rate in service occupations (which include food service jobs) was 27.1% in April 2020.

While data on how these recent changes have affected coverage within households are not yet available, we can use the CPS ASEC to examine coverage for workers in these jobs in 2018 and their families.

We focus on the following occupations that are among those affected during the pandemic and therefore most at risk of losing health coverage: food preparation and serving; building and grounds cleaning and maintenance; personal care and service; and retail sales.

Collectively, 39.6 million people worked in these jobs in 2018, representing 23.6% of all workers.

Some key findings:

  • * The majority (55.2%) of workers (about 21.9 million) in one of these occupations had ESI plans.
  • * Slightly under a third (32.0%) of workers in these jobs were the policyholders. That is, the plan was in their name and their employment (as opposed to their spouse’s or a parent’s employment) made them eligible to enroll.

What About the Children?

In 2018, about 38 million children under 19 years had health insurance through their parents’ ESI plan. This represents nearly one-half (49.1%) of all U.S. children under 19.

About 22.8% of children with parents employed in the above occupations (food preparation and serving; building and grounds cleaning and maintenance; personal care and service; and retail sales) were on a parent’s ESI plan. This means that ESI plans with workers in jobs likely affected by a shrinking economy covered 4.3 million children in 2018.


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