Released by the United Hospital Fund - Lessons from the Great Recession: How Medicaid Enrollment Patterns of a Decade Ago Can Inform Policy During the Pandemic

Tuesday, June 9, 2020

Released by the United Hospital Fund - Lessons from the Great Recession: How Medicaid Enrollment Patterns of a Decade Ago Can Inform Policy During the Pandemic

NEW YORK, NY—June 9, 2020—A HealthWatch report released today by United Hospital Fund (UHF) analyzes New York State Medicaid enrollment trends during the “Great Recession” of 2007-2009, and the impact of state and federal actions taken then, in order to shed light on what to expect during the current pandemic-sparked economic downturn.

The state’s estimated unemployment rate nearly doubled between 2007 and 2009, growing from 4.8 percent in December 2007 to a peak of 8.9 percent in November 2009. Medicaid enrollment grew by over 400,000 individuals during the same period, a 10 percent increase. But as the economy recovered and unemployment rates returned to pre-recession levels, Medicaid enrollment continued to grow. Ten years later, nearly 6 million people are enrolled as of October 2019—roughly one-third of the state’s residents and 2 million more than were covered in December 2007.

The report, Lessons from the Great Recession: New York Medicaid Enrollment During the COVID-19 Crisis,observes that, if job losses in 2020 are initially concentrated among low-income New Yorkers, Medicaid enrollment may grow somewhat more modestly than during the previous downturn because many may already be enrolled in the program.

However, more widespread unemployment that disrupts the health coverage of higher income people and depresses their incomes below Medicaid eligibility thresholds could drive larger increases in Medicaid enrollment—for instance, in households where COBRA premiums become unaffordable and where monthly incomes fall below the ranges for enrollment into other publicly financed health programs. The pandemic itself may also hasten enrollment, as newly uninsured individuals seek affordable coverage for COVID-19 testing and treatment. Early reports from the New York State Department of Health suggest that the enrollment growth rate since February 2020 has been four times the average monthly growth rate during the first year of the Great Recession.

“The COVID-19 pandemic will likely shape New Yorkers’ need for coverage in unprecedented ways, and the state will face daunting challenges in facilitating Medicaid enrollment during a major public health crisis,” said Nathan Myers, director of UHF’s Medicaid Institute and a co-author of the report. “But Medicaid will remain a vital source of coverage, and sustaining and building on New York’s progress in improving access to Medicaid will be crucial for serving those in need during these uncertain times...

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