The COVID-19 pandemic and the mitigating actions in response by citizens and governments alike have precipitated unprecedented economic disruption in the United States. The second quarter of 2020 marked the largest single-quarter economic contraction in modern U.S. history, driving unemployment rates from historically low levels in February to peaks last seen during the Great Depression.
The unraveling and recovery of the U.S. economy have had and will continue to have a similarly disruptive influence on the enrollment in and composition of U.S. health insurance markets. These impacts will be felt throughout the health system, including in state Medicaid budgets and hospital, physician, and pharmaceutical margins, as well as in the financial performance of commercial and Medicaid health plans.
To understand the interconnected nature of economic changes and health insurance coverage and to project impacts to U.S. health insurance markets, Milliman built a tool referred to as the COVID-19 Advanced Population Shift model. This model combines detailed information on the economic status, health insurance coverage, and health status of each state’s population prior to the COVID-19 pandemic with emerging information on the economic impact of the pandemic response. It allows forecasting the resulting shifts in enrollment and population morbidity across the healthcare markets while providing insight into the key factors driving change. Milliman’s Fritz Busch, Lindsy Kotecki, and Jeff Milton-Hall summarize the findings in this paper.