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COVID-19, State Efforts

State Spotlight September 12, 2020

Published On September 12, 2020

By: Joanna Dornfeld

New resources to help you manage during the COVID crisis.

US of Care Releases A System Under Stress, Exacerbated: The Employer-Sponsored Health Insurance System at a Crossroads

Over the past seven pandemic-ridden months, between six million and 27 million people may have lost the health insurance they previously received from their employer. These people are losing health coverage during a historic pandemic — a time when affordable access to care is more critical than ever. The health of each individual is so clearly linked to the health of us all.

Our health care system – which relies on job-connected health insurance for more than 160 million Americans – is complex. We need to ask critical questions about how health care security can become more affordable and durable in good times and in bad. To assist in this effort, USofCare is examining approaches utilized by several states and leading private companies to control the costs increasingly straining the system.

USofCare is bringing together policy experts, employers, innovators and people experiencing our health care system to understand what currently works and what alternatives could look like. Our current job-based system has been in place for decades, and now it is time to think about a system that can give people the health care coverage security they want no matter what life may bring. USofCare wants to be a part of the solution and we’d like you to join us. If you want to join our conversation and USofCare’s effort to develop solutions, email Andrew Schwab, Director of Policy, Federal Affairs and Partnerships, at [email protected].

2020 Scorecard on State Health System Performance

Yesterday, US of Care partner, The Commonwealth Fund, released its 2020 Scorecard on State Health System Performance yesterday. The scorecard assesses all 50 states and the District of Columbia on 49 health care measures, covering access, quality, service use and costs of care, health outcomes, and income-based health care disparities.

Key Findings:

  • Americans are living shorter lives than they did in 2014, and Blacks are twice as likely as whites to die from treatable conditions. Black Americans, who also have suffered disproportionately during the COVID-19 pandemic, were twice as likely as whites to die early from treatable conditions such as diabetes, heart disease, appendicitis, and certain cancers. Several of these conditions are key risk factors for COVID-19. These disparities were found in every state. Mississippi, Arkansas, and Oklahoma reported the highest rates of premature deaths among the Black community.
  • Health coverage gains have stalled, while affordability of insurance and out-of-pocket costs have worsened. Early coverage gains associated with the passage of the Affordable Care Act (ACA) have stalled, and even begun to erode, in most states. Between 2014 and 2016, every state saw at least a 2 percent annual reduction in uninsured rates. Since 2016, 23 states saw those gains flatten and 22 saw uninsured rates creep up.
  • Health care prices drive spending growth and rising consumer health care costs. In every state, the prices that commercial insurers paid for hospital inpatient care were higher than Medicare prices. Insurers often pass along those higher costs to employers in the form of higher premiums and deductibles that workers ultimately shoulder. The economic contraction could make these costs even less affordable for workers if they suffer declines in income and wages and lose employer-sponsored insurance.
  • Public health dollars are being stretched thin at a time when states face unprecedented challenges from COVID-19. Between 2014–2015 and 2017–2018, per capita public health spending was flat in most states or increased only modestly.

To review your state’s scorecard go to

US of Care 2020 Health Care Legislative Candidate Guides

US of Care state legislative candidate guides include key health care data and effective health care policy solutions as well as key messages – informed by our current COVID experience – to inform candidates’ priorities and conversations with voters about their health care challenges. All of the candidate education materials can be found on USofCare’s Resources page.

Health care remains one of the most important problems facing America. Voters are concerned about access to and the cost for health care and insurance. The COVID-19 pandemic has illuminated the need for effective solutions that address both the immediate challenges and the long-term gaps in our health care systems to ensure people can access quality health care they can afford.

If you would like more information about USofCare’s candidate education materials or would like to request a briefing, contact us at [email protected].

State Action: How Colorado stakeholders used a creative solution to improve access to health insurance during the COVID-19 pandemic

While COVID-19 has continued to be the most critical health care priority among state policymakers, states have also made progress advancing other promising health care priorities. In Colorado, our partners were instrumental in passing legislation in June to improve access to more affordable health insurance. This blog provides an overview of the policy, how it is structured to help people, and how other states can learn from Colorado’s approach. Stay tuned for a second part of this blog, where we interview the authors on building a coalition to help bring more affordable coverage to Coloradans.

United States of Care COVID Rapid Response for State Leaders

USofCare’s mission to ensure that every single American has access to quality, affordable health care has never been more important than in the current public health crisis. We have been providing immediate support for state and federal government and public response needs, leveraging our expertise (including our Board and Founder’s Council), capacity, network and resources to support effective responses to the COVID-19 pandemic. Teams of USofCare’s staff are researching and responding to incoming requests, which can be sent to [email protected].