Banning: Jobs report on health care

I’ve been trying to digest what the release of April unemployment numbers on Friday mean for health care. Nonfarm payrolls fell by 20.5 million and the unemployment rate rose to 14.7%.


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However, the “real” unemployment rate, which includes workers not looking for jobs and the unemployed, surged to 22.8%. The healthcare sector lost 1.4 million jobs last month, mostly on the ambulatory side.



According to a report from the Robert Wood Johnson Foundation an estimated 25 – 43 million people could lose their employer-sponsored health insurance: “Rising unemployment is expected to significantly alter the health insurance coverage landscape, as millions who lose their jobs and their dependents enroll in Medicaid, purchase Marketplace coverage (assuming they have the means) or become uninsured.” The report also found that in non-Medicaid expansion states, like Texas, about 40% of those individuals will become uninsured.

Link: Robert Wood Johnson Foundation

Health Management Associates, a well-regarded, independent national research and consulting firm, also estimated how the economic downturn could impact individual state enrollment in Medicaid, Employer Sponsored coverage as well as the potential change in the number of uninsured individuals. Based on HMA’s modeling Texas’ Medicaid rolls could grow by 1,089,000; employer sponsored insurance coverage would drop by 1,952,000 and Texas’ already dismal uninsured rate would grow by 784,000.

Link: Health Management Associates

Those are some damn scary projections. Couple those projections with an info graphic (attached) that our friends at Gist Healthcare produced based on a recent Morning Consult poll on consumer confidence showing nearly half of those polled plan to wait two to six months before scheduling a routine in-office visit and almost one in ten not comfortable going to a doctor’s office in person for a year or more – it all adds up to a pretty ugly picture for patients, physicians and the viability of our health care system – which makes up 20% of our economy.

Link: Morning Consult

There are some pretty simple and common-sense solutions we should pursue, like expanding Medicaid, but Texas has starved down and ignored its safety net providers for so long that, absent some investments we can make now to our safety net, I’m concerned Texas won’t have the infrastructure or capacity to provide care for those who need it. Politically, Medicaid expansion is complicated as the majority of elected Republicans are still vehemently against expanding Medicaid coverage and AG Paxton continues his efforts to overturn the Affordable Care Act. As more Texans find themselves and their families uninsured and at risk of even greater financial ruin by an unexpected health event, policy makers should be pursuing new and innovative strategies to give patients access to health care services and/or alternative health insurance coverage options, otherwise health care will become an even more potent political weapon for Democrats.



Tom Banning is the CEO of the Texas Academy of Family Physicians. He writes an occasional column for State of Reform about topics of national interest, as well as some steeped in a career in Texas health care politics.