As difficult as the past year was, it could have been significantly worse without measures to keep people insured, fed and in their homes, according to new data.

The Colorado Health Access Survey, which polled more than 10,000 Colorado households, found the uninsured rate stayed essentially stable between 2019 and 2021, and fewer people reported they were worried about losing their homes or going without food.

The survey asks people about their experiences over the previous year, so 2021’s data provides a sense of what has happened since the arrival of the coronavirus in spring 2020.

“The social safety net held,” said Jeff Bontrager, who was the principal researcher working on the study at the Colorado Health Institute. “We could have seen skyrocketing uninsured rates, for example.”

About 6.6% of Coloradans reported they were uninsured in 2021, which isn’t significantly different from the 6.5% reported in 2019. Latinos were more likely to be uninsured than they were in 2019, however, which might be related to rhetoric around immigration last year, Bontrager said.

The data found fewer people had coverage through their jobs or the individual market, but Medicaid seems to have absorbed those who lost other forms of insurance. Roughly one in four Coloradans reported Medicaid was their primary source of insurance over the previous year.

A federal requirement to keep Medicaid recipients enrolled during the public health emergency reduced “churn” off the program, which likely contributed to its increased share, Bontrager said. In normal times, if a family’s income rises too much when it comes time for their annual review, they lose Medicaid eligibility, though they could come back if their income drops again.

“People who were enrolled in Medicaid stayed in Medicaid,” he said.

Policy choices also may have reduced the number of people dealing with housing instability, Bontrager said.

About 5.6% of people surveyed in 2021 reported concern about losing their housing in the coming months, down from 6.7% in 2019. The eviction moratorium was likely a factor, though renters still were more likely to report they were worried about falling behind than homeowners with mortgages, he said.

Food insecurity also decreased, with 8.1% of Coloradans reporting they ate less than they thought they should for financial reasons. In 2019, 9.6% of those surveyed said they were skimping on food. That may reflect efforts by nonprofits and schools to get food to vulnerable families, as well the effect of federal stimulus payments, Bontrager said.

Still, the pandemic’s effects were significant, and hit some groups significantly more than others. Black, American Indian and Hispanic people who responded were more likely than their white counterparts to say they’d struggled on almost every front, whether it was paying for rent or food, losing a job, or going without needed health care.

Of all people over 16 who were surveyed:

  • 38.3% reported their mental health had worsened
  • 29.3% lost at least some income
  • 17.2% struggled to pay for necessities
  • 11.9% lost a job

The percentage of people reporting poor physical health actually dropped, but the number dealing with mental health struggles rose. Almost 24% of people 5 and older reported they experienced poor mental health on at least eight days in the month before they took the survey. In 2019, slightly more than 15% said the same thing.

Adults between 19 and 29 reported the biggest impacts, with 35% reporting poor mental health. The rate gradually decreased with age, with only about 12.5% of people 65 and older saying their mental health was poor.

Teens and tweens also were more likely to report struggling, with 18.5% saying their mental health was poor, up from 14% in 2019. Children younger than 10 reported little change, however, with 7.2% reporting poor mental health.

While there is some positive news, since respondents were more likely to report seeking care for their mental health, it will be a challenge to serve all of the people who report struggling, especially in a system without enough providers, Bontrager said.

“Mental health troubles really did represent a second health crisis,” he said.

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