In April 2020, Advisory Board conducted a web-based survey to ask over 3,500 Americans about their health plan experience during the Covid-19 pandemic. To be eligible for the survey, respondents had to have health insurance and reside in the U.S.

Americans have been losing employment at record rates. Our survey data supports this with 29% of respondents saying that they have lost wages in the past three months due to Covid-19 or social distancing.

Medicaid members are most likely to lose their entire jobs rather than a portion of their wages, with 41% of members who have lost wages saying they’ve lost all their wages. These members may have had lower wage jobs to begin with in addition to struggling more with homelessness or food insecurity because of the unemployment.

Employer-sponsored members are also losing a portion of their wages with 52% of members who have lost their wages saying they lost a quarter of their wages. Companies are losing revenues due to social distancing and are cutting wages when they can but also furloughing staff when necessary.

Individual market members have been the hardest hit with 46% reporting pay cuts. After the ACA, industries such as service jobs, farming, construction, and transportation saw the biggest increase in insurance coverage so these are most likely the industries represented in the individual market and Medicaid. For example, a waiter could be working fewer hours as restaurants only offer delivery or takeout.

A consequence of these pay cuts and layoffs is that people are changing their health insurance plans. Of the survey respondents who changed their plan in the past three months, 36% did so because of Covid-19 and 54% of these people originally came from employer sponsored insurance.

While recessions increase the number of uninsured, the current pandemic is dampening this as people still want insurance. According to our survey, 12% of uninsured Americans are now seeking insurance to protect themselves from Covid-19 testing and treatment costs.

What does all this mean for health plans?

Medicaid will see higher enrollment and members will face more financial issues. Members don’t expect plans to provide financial assistance but as Medicaid enrollment increases, the need for social support will also increase. We see plans playing one of five roles to support members: funder, convener, expert, advocate, and creator. Read more about each of these roles in our Medicaid Growth Outlook.

Employer-sponsored insurance will decline and employers will start asking plans for more ways to save costs. The last recession led to cuts in benefits and a rise in deductibles. This time we expect to see employers debate encouraging public coverage or growing more assertive in their management of how employees use health care. Read more in How Covid-19 will impact employer coverage.

Individual market members might need premium deadline extensions even if they are receiving subsidies if they have lost their jobs. People who are newly enrolling in the individual market will need help choosing a product and applying for subsidies. Also, individual members will become even more price conscious as they shop for products in 2021. To learn more about how Covid-19 will impact the individual market, view our on-demand Individual Market Outlook webinar.

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