New data: Lack of health insurance heightened COVID-19’s impact on Alabama communities, underscoring need for Medicaid expansion
Updated April 29, 2021
MONTGOMERY, Ala. – Lack of health insurance coverage was a key factor in the spread and toll of COVID-19 in Alabama, according to a Families USA report, The Catastrophic Cost of Uninsurance, updated last month. The report shows how the impact of uninsurance extends beyond uninsured individuals to the communities where they live.
“When people without health insurance begin to feel sick, they often delay seeking medical care or forgo care altogether because of cost concerns,” the report finds. “Not only does this place the individual patient in danger, it lets disease spread undetected and unchecked to family members, neighbors, co-workers, and others.”
The Families USA report is based on a groundbreaking, peer-reviewed study published late last year finding that each 10% increase in the proportion of a county’s residents who lacked health insurance was associated with a 70% increase in COVID-19 cases and a 48% increase in COVID-19 deaths. The updated version includes more recent data through Feb. 1, 2021, and county-level numbers in every state, highlighting the 40 hardest-hit counties in several categories.
More than 2,900 COVID-19 deaths ‒ or 38% of all COVID-19 deaths in Alabama through Feb. 1, 2021 ‒ were associated with high community rates of uninsurance, the report finds.
The vast majority of uninsured Alabamians would qualify for coverage if the state expanded Medicaid. Medicaid expansion would provide health insurance to adults with low incomes who make too much to qualify for Alabama’s Medicaid program but not enough to afford a private health insurance plan. More than 200,000 Alabamians are in the coverage gap, and an additional 140,000 are struggling to pay for coverage they cannot afford.
“Alabama’s failure to expand Medicaid left us more vulnerable than many states to the ravages of the COVID-19 pandemic,” said Jane Adams, campaign director of Alabama Arise and director of the Cover Alabama Coalition. “Because hundreds of thousands of Alabama families lack health insurance, they are more at risk of delaying care -- both for chronic conditions and for infections like COVID-19. The best way for Governor Ivey to honor the lives of those we lost in the pandemic is to expand Medicaid coverage, as 38 other states have done, and finally open a pathway for Alabama families to get affordable and consistent care.”
The report finds that 21 Alabama counties saw more than half of their COVID-19 cases tied to high rates of uninsurance, resulting in higher rates of community spread: Barbour, Blount, Cherokee, Chilton, Choctaw, Clay, Cleburne, Cullman, DeKalb, Escambia, Franklin, Geneva, Henry, Jackson, Lawrence, Marshall, Monroe, Pike, Sumter, Washington and Winston. DeKalb County was hit especially hard, with 63% of COVID-19 cases and 52% of COVID-19 deaths linked to a high rate of uninsurance.
“It is hard to believe, but despite the deadliest pandemic in more than a century, far too many politicians still haven’t figured out that we’re all in this together ‒ that if some of us can’t afford health care, all of us are at risk,” said Stan Dorn, the report’s author and director of the National Center for Coverage Innovation at Families USA.
“People without insurance often delay going to the doctor even if they start to feel sick. Not only are they in danger, the virus spreads, undetected, to everyone whose paths they cross.
“It’s finally time to make sure that, in the country with the world’s best medical research and treatment, no one has to worry that they can’t afford health care or has to choose between going to the doctor when they get sick and feeding their family.”
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About Cover Alabama: The Cover Alabama Coalition is a nonpartisan alliance of more than 110 advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.