Health Care Access and Affordability Among US Adults Aged 18 to 64 Years With Self-reported Post-COVID-19 Condition.

Importance: Many US adults report having post-COVID-19 condition (PCC), but little is known about their access to health care. Objective: To estimate the association of PCC with access and affordability challenges among US adults aged 18 to 64 years. Design, Setting, and Participants: This survey study used data from the Health Reform Monitoring Survey, a probability-based internet survey conducted June 17 to July 5, 2022. Participants included a nationally representative sample of 9484 US adults ages 18 to 64 years drawn from the Ipsos KnowledgePanel. Main Outcomes and Measures: Self-reported PCC was defined as experiencing symptoms more than 4 weeks after first having COVID-19 that were not explained by another condition or factor. Access and affordability outcomes included having a usual place of care; forgoing care in the past 12 months because of costs, difficulty finding clinicians, or difficulty using health insurance; having problems paying family medical bills in the past 12 months; and having past-due medical debt. Results: Of 19 162 panel members recruited for the survey, 9599 individuals completed the survey (completion rate, 50.1%) and 9484 respondents were included in the final analytic sample (4720 females [50.6%, weighted]; mean [SD] age, 41.0 [13.5] years). A total of 3382 respondents (36.4%; 95% CI, 34.7%-38.2%) reported ever being diagnosed with COVID-19, among whom, 833 respondents (22.5%; 95% CI, 20.9%-24.2%) reported currently having PCC. After adjustment for differences in demographic, health, and geographic characteristics, adults with PCC were more likely than 2549 adults with a COVID-19 diagnosis but no report of PCC and 6102 adults never diagnosed with COVID-19 to report unmet health care needs in the past 12 months because of the following challenges: costs (27.0%; 95% CI, 23.2%-30.7% vs 18.3%; 95% CI, 15.9%-20.7% and 17.5%; 95% CI, 15.4%-19.6%) and difficulties finding clinicians accepting new patients (16.4%; 95% CI, 14.3%-18.4% vs 10.1%; 95% CI, 8.8%-11.5% and 10.7%; 95% CI, 9.6%-11.8%), getting a timely appointment (22.0%; 95% CI, 19.3%-24.8% vs 14.4%; 95% CI, 13.2%-15.7% and 13.9%; 95% CI, 12.9%-14.8%), and getting health plan care authorization (16.6%; 95% CI, 14.6%-18.6% vs 10.8%; 95% CI, 9.6%-12.1% and 10.3%; 95% CI, 9.4%-11.2%) (P < .001 for all comparisons). Conclusions and Relevance: This study found that adults aged 18 to 64 years with PCC were more likely than other adults to have difficulty getting and paying for health care. These findings suggest that policies aimed at improving access and affordability may focus on accelerating development of treatments and clinical guidelines, training clinicians, and addressing insurance-related administrative and cost barriers.

Adults in Families Losing Jobs During the Pandemic Also Lost Employer-sponsored Health Insurance

From the Document: The recession caused by the COVID-19 [coronavirus disease 2019] pandemic is expected to lead to losses of employer-sponsored health insurance coverage (ESI) and a rise in uninsurance (Banthin et al. 2020;Garfield et al. 2020;Garrett and Gangopadhyaya 2020). These coverage losses would test the health care safety net established by the Affordable Care Act (ACA). Further, the strength of this safety net varies across states: adults who lose ESI in the 15 states that have not expanded Medicaid under the ACA face greater challenges finding replacement coverage (Garfield et al. 2020).COVID-19 (Disease);Epidemics;Public health

Who Did Not Get the Economic Impact Payments by Mid-To-Late May, and Why?: Findings from the May 14-27 Coronavirus Tracking Survey

From the Document: The Coronavirus Aid, Relief, and Economic Security (CARES) Act provided most US households with one-time economic impact payments (also referred to as recovery rebates or stimulus payments) to mitigate the negative economic effects of the COVID-19 [coronavirus disease 2019] pandemic. The Internal Revenue Service (IRS) sent these payments out between April 10 and June 3 to all 159 million people for whom it had the necessary information on file. Millions of people will eventually receive their payments after they file their 2019 or 2020 income tax returns or take other actions to provide the IRS with up-to-date information on where to send the money. But some experts estimate that 12 million eligible people who are not required to file income tax returns were at risk of not getting the payments--in many cases, because they have difficulty applying for the payment or are not aware that they are even eligible to receive it (Marr et al. 2020).COVID-19 (Disease);Coronavirus Aid, Relief, and Economic Security (CARES) Act

Hispanic Adults in Families with Noncitizens Disproportionately Feel the Economic Fallout from COVID-19

From the Document: The COVID-19 [coronavirus disease 2019] pandemic threatens to upend the well-being of many Hispanic adults and their families. Already, the pandemic is affecting Hispanic adults' family financial security to a greater extent than other racial/ethnic groups. As of late March/early April 2020, nearly 6 in 10 nonelderly Hispanic adults were in families where someone lost a job, work hours, or work-related income because of the coronavirus outbreak, and close to 5 in 10 experienced some material hardship in the past 30 days (Karpman et al. 2020). Underlying these disparities for Hispanic adults is their disproportionate representation in industries most likely affected by the pandemic and their lower likelihood of having jobs that can be performed from home (Berube and Bateman 2020).COVID-19 (Disease);Epidemics;Financial security