Economic Progress Institute predicts move away from employer-based health insurance

PROVIDENCE Rhode Island ranked third in the nation in the lowest rate of residents that are not covered by health insurance in 2019, but local nonpartisan research and policy organization Economic Progress Institute says the way Rhode Islanders are covered might be in for a change.

New data released by the U.S. Census Bureau on Tuesday said that in 2019, there were 43,000 Rhode Islanders, or 4.1%, who lacked health insurance. This is roughly the same rate as 2018, but less than half the rate in 2013 before the Affordable Care Act went into effect.

The national share of uninsured individuals in 2019 was 9.2%.

RHODE ISLAND ranks No. 3 for lowest rate of residents left uninsured, according to data collected by the U.S. Census Bureau’s American Community Survey’s one-year estimates. / COURTESY THE ECONOMIC PROGRESSIVE INSTITUTE

However, the Economic Progress Institute said this data does not reflect the impact that the pandemic has had on health insurance coverage in the state. More than 60% of Rhode Islanders were covered by employer-based health insurance, according to information from the Census Bureau. Due to the high unemployment rate caused by the effects of COVID-19, the Institute said there has been significant loss of health insurance coverage as well.

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While data from the Census Bureau on COVID-19’s impact on the loss of insurance likely won’t come out until 2021, the Economic Progress Institute estimates that some Rhode Islanders are at risk of losing coverage. The organization said that  COVID-19 might serve as a transitional period to reevaluate insurance links to employment, and not just due to loss of employment.

“As rates rise in the commercial insurance market, there may be a natural move away from employer-based health insurance, especially for small businesses,” said Linda Katz, the Economic Progress Institute’s Policy Director. “It’s becoming harder for employers to afford it and for employees to pay their share.”

Katz did say that the majority of those who lost their jobs in Rhode Island throughout the pandemic thus far are in hospitality and retail, and likely get their insurance from Medicaid as it is, and do not have it linked to their employer.

In just six months, from February though August of this year, overall enrollment in Medicaid ion Rhode Island increased by 6.9% with enrollment population rising from 73,140 to 84,799 – an increase of almost 16%. Medicaid enrollment for children and families rose by almost 5%.

“The Affordable Care Act opened the door to Medicaid Insurance for 75,000 low-income single adults and allowed 34,0000 Rhode Islanders to buy coverage through HealthSource RI,” said Katz.

RHODE ISLAND’s low uninsured rate continued in 2019, but how the state’s uninsured numbers will hold after the coronavirus pandemic left thousands jobless is yet to be seen. / COURTESY THE ECONOMIC PROGRESS INSTITUTE

These numbers that represent the increasing enrollment include several thousand newly enrolling individuals as well as those who remained eligible under the federal requirement that states must provide continuous coverage to enrollees during the coronavirus health crisis to receive the enhanced federal match for Medicaid spending.

The federal match program has provided Rhode Island an additional $83.2 million in federal funds this year, according to the Economic Progress Institute.

“It is even more important in this time of health crisis that these public programs remain strong,” said Katz. “It is critical that the federal government move rapidly to provide relief to states, including continuing and even increasing the enhanced [federal match for Medicaid spending]. Without swift and comprehensive federal action, residents and the state’s economy will suffer.”

Katz said she expects health insurance and delivery of care to change because of lasting effects of COVID-19, including the coverage of telehealth and a heightened focus on housing and food insecurity.

“So much of health care isn’t just the delivery of care,” said Katz. “And COVID has heightened the disparities that have always existed.

Alexa Gagosz is a PBN staff writer. Contact her at You may also follow her on Twitter at @AlexaGagosz.