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The Catastrophic Cost of Uninsurance: COVID-19 Cases and Deaths Closely Tied to America’s Health Coverage Gaps

By Stan Dorn, Rebecca Gordon,


For decades, experts in contagious disease have warned that health insurance gaps accelerate the spread of epidemics. When people without health insurance begin to feel sick, they often delay seeking medical care or forgo care altogether because of cost concerns. 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.

These warnings came true during the coronavirus pandemic. According to recent groundbreaking research, 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.

This report uses that research to address one fundamental question: If everyone in America had health insurance, how many people who contracted COVID-19 could have been spared, and how many who died might still be with us today? We find as follows:

  • Nationally, roughly 1 out of every 3 COVID-19 deaths are linked to health insurance gaps.
  • More than 40% of all COVID-19 infections are associated with health insurance gaps.
  • By August 31, 2020, health insurance gaps were linked to an estimated 2.6 million COVID-19 cases and 58,000 COVID-19 deaths. By February 1, 2021, 10.9 million infections and 143,000 COVID-19 deaths may have been associated with health insurance gaps.

President Biden’s American Rescue Plan, approved by the House and now before the Senate, would make all of us safer by substantially reducing the number of uninsured. But our leaders can’t stop there. The pandemic’s bitter lessons include this one: we can no longer afford to be the only advanced country that leaves millions of its people without health coverage. When some of us are uninsured, all of us are at risk. It is finally time to make sure that everyone in America gets the health care they need to thrive.

Report Appendices: