In the drive to gut Medicaid, spotlight on Jeff Van Drew (NJ-2)

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Pink tie/weak MAGA?

See updates for 5/6/25 and 5/7/25 at bottom.

I have an op-ed in NJ.com questioning whether Rep. Jeff Van Drew (R-NJ-2) will hold to his promise to “protect” Medicaid for his constituents, including those covered via the ACA Medicaid expansion.

Van Drew, a formerly Democratic House representative in South Jersey who went MAGA and switched parties, has been something of a fulcrum in the Republican House drive to pass legislation cutting hundreds of billions of dollars in federal Medicaid funding (he’s at least a frequent source in reports on that struggle).

On the one hand, Van Drew has more than 165,000 Medicaid/CHIP enrollees in his district, including more than 50,000 low-income adults covered via the ACA Medicaid expansion. Unlike most Republicans, when he vows to “protect” Medicaid, he includes “low-income families” — i.e., the ACA expansion population — in the groups to be protected. And yet, he voted for the resolution targeting hundreds of billions of dollars in cuts to Medicaid over ten years. And there are signs he will go along with essentially repealing the expansion - -that is, cutting federal funding for it enough to make it fiscally impossible for states to continue.

The op-ed spotlights the contradictions in Van Drew’s words and deeds concerning Medicaid and encourages constituents (and perhaps reporters) to press him about those contradictions. I hope you’ll give it a read.

Cut Medicare, not Medicaid

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As soon as House Republicans’ budget resolution was published, it was clear that almost all of the $880 billion 10-year spending cut target for the Energy and Commerce Committee would have to come out of Medicaid, because Medicaid accounts for 93% of projected 10-year spending under E&C’s purview — excluding Medicare. And Medicare, unlike Medicaid, is a sacred cow.

That’s too bad, because while the cuts that Republican lawmakers are proposing to Medicaid funding will likely cause 10-20 million people to lose coverage, federal payments to private Medicare Advantage plans, which now enroll 54% of Medicare beneficiaries, can and should be cut by something in the neighborhood $880 billion over ten years — a reduction that would still leave the plans overpaid.

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Don’t ask me, ask MedPAC, the Medicare payment advisory commission that reports annually to Congress on Medicare spending. According to MedPAC’s March 2025 report, “In 2025, we estimate that Medicare will spend 20 percent more for MA enrollees than it would spend if those beneficiaries were enrolled in FFS Medicare, a difference that translates into a projected $84 billion.” Projecting that estimate forward, the Committee for a Responsible Federal Budget estimates that MA plans will be overpaid by $1.2 trillion from 2025-2034.

Tell Congress: Hands off Medicaid!

 

Tell Congress: Hands off Medicaid!

·      Huge cuts to Medicaid are pending: The budget resolution that passed the House with no Democratic votes directs the Energy & Commerce Committee to cut federal spending by $880 billion in ten years – almost all of which would have to come from Medicaid.

·     The Affordable Care Act’s Medicaid expansion is on the chopping block: The ACA provides Medicaid to 21 million poor and near-poor adults (550,000 in our state). House Republican leadership has made it clear that they intend to eliminate dedicated federal funding for the ACA Medicaid expansion – a $650 billion spending cut.

·       Uninsuring millions: If the federal 90% contribution for “expansion” enrollees is eliminated, no state will be able to afford to maintain the expansion.  Based on past estimates by the Congressional Budget Office, 15-20 million people will lose coverage.

·      Republicans are lying about their plans: Republican leadership, and on-board representatives  like Tom Kean Jr. (NJ-7), say that they will “protect” Medicaid for children, seniors and the disabled and only cut “waste, fraud, and abuse.” In Republican-speak, “waste” means coverage for low-income adults.

·      Say no to work requirements: Republicans also aim to make all states impose “work requirements” on most adult Medicaid enrollees – though the vast majority of non-disabled enrollees either work or are caregivers or students.  Work requirements have been tried – and the red tape drives eligible Medicaid recipients off the rolls in droves – as Republicans intend.

Take Action

·       Contact NJ’s Republican House Reps: Tell them Hands off Medicaid! Preserve the ACA Medicaid expansion. Say no to work requirements.

Jeff Van Drew (NJ-2) --  (202) 225-6572 or ( 609) 625-5008
Chris Smith (NJ-4) –  (202) 225-3765 or (732) 780-3035
Tom Kean Jr. (NJ-7) -- (202) 225-5361 or  (908) 547-3307

Van Drew and Smith, both of whom would prefer not to cut Medicaid, are receptive to out-of-district calls; Kean, not so much.

Defend the ACA Medicaid Expansion directly

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The Maginot Line

Forgive me for slipping into Ancient Mariner mode here, but I must again voice my obsessive plea to elected Democrats, healthcare advocates, and all those who don’t won’t to see 15-20 million Americans uninsured: Defend the ACA Medicaid Expansion! Explicitly!

As documented in my last two posts (1, 2), House Republican leadership is almost certainly coalescing on defunding the expansion — that is, ending the 90% federal match rate for low-income adults rendered eligible by the expansion’s criteria — 21 million of them at last count, as of June 2024. Since Trump ordered his troops to “cherish” Medicaid and not “touch” it while also commanding passage of a budget resolution that would cut hundreds of billions of dollars in Medicaid funding, they justify this $650 billion cut in the name of “protecting” Medicaid for children, the disabled, and elderly enrollees — those Medicaid was “originally designed for.”

By long reflex, stakeholders defending Medicaid more often than not mount their defense in the name of the same vulnerable groups Republicans are vowing to “protect.”* Here is the core defense in a letter from Families USA, co-signed by more than 300 advocacy groups, to Senate Majority Leader John Thune, asking him to reject the house budget resolution:

WSJ editorial board: Insuring low-income "able-bodied" adults is a waste of federal money

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Providing ideological cover for Republicans who seek to cut hundreds of billions of dollars out of federal Medicaid funding, the Wall Street Journal editorial board would have you believe that federal Medicaid spending is out of control, that rich states get more than their fair share of federal Medicaid funding, that cuts to the projected spending growth rate under current law are not cuts, and that Medicaid isn’t much worth having anyway. That’s all false of course.

Let’s look at these nostrums one by one.

Undue spending in Medicaid growth. The WSJ editorialists write:

Medicaid spending as a share of federal outlays rose to 10% from 7% between 2007 and 2023, while the share of Social Security and Medicare remained stable.

Well yes, of course. The ACA Medicaid expansion, rendered optional by the Supreme Court in 2012, offered Medicaid eligibility to all lawfully present U.S. adults with income up to 138% of the Federal Poverty Level, excepting those subject to a federal 5-year bar on new immigrants. As of the program’s full launch in 2014, 24 states had enacted the expansion, and as of now, 40 states plus D.C. have done so. Medicaid enrollment has accordingly grown by 38% since 2013 (and had swelled even higher as of 2023, the year cited by the Journal, as a result of the pandemic-induced three-year moratorium on disenrollments. Medicaid enrollment has dropped 17% since the 2023 peak.)

Democratic states grab more than their fair share of federal largesse. We are asked to believe:

Democratic-run states receive disproportionately more federal Medicaid dollars. New York received $3,046 for each state resident in 2023 based on the most recent federal data. Federal Medicaid dollars also subsidize California ($2,167 per resident) and Illinois ($1,715) much more than Florida ($991) and Texas ($1,239).

---

Girding for healthcare battle at Families USA's Health Action 2025

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The Families USA conference convened in February 2017 felt a bit like the U.K. after the Dunkirk evacuation — an all-hands-on-deck mobilization to prevent Republicans from tearing down what many of those present* had worked for decades to build (the ACA, and Medicaid as it had evolved over decades).

It was my first Health Action conference, and I was heartened by the concentrated expertise and determination of the speakers — activists and advocates, healthcare scholars, former government officials — who shared a wealth of practical knowledge as to how to move elected officials and mobilize people with stories to tell.

Though I’m not a Lord of the Rings fan, I was reminded of a scene where the fellowship accompanying Frodo and his fellow hobbits on their quest to deep-six the ring of power is assaulted by a pack of super-wolves. As the wolves circle, there’s this exchange:

My heart’s right down in my toes, Mr. Pippin,’ said Sam. ‘But we aren’t etten yet, and there are some stout folk here with us. Whatever may be in store for old Gandalf, I’ll wager it isn’t a wolf’s belly.’

The dominant chord was struck by incoming FUSA executive director Frederick Isasi: "Our action should lead to inaction" — that is, failure to pass a repeal bill. That dictum proved prophetic.

At this year’s conference, the mood was grimmer but the determination was the same, as was the focus on grassroots action. As to the legislative prospects compared to 2017, both the stakes and the odds are hard to gauge — they appear both better and worse.**

Will Medicaid's "great unwinding" when the PHE ends trigger a "great uninsuring"?

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During the pandemic, from February 2020 to May 2022, Medicaid enrollment increased by 18 million, or 29%, according to administrative data that CMS collects from states. That's mainly because of a moratorium on disenrollments that began in March 2020 and has yet to end. The moratorium will end when the federal government declares an end to the  Public Health Emergency, which will happen in mid-January 2023 at the earliest (the PHE has been extended repeatedly in 3-month increments). 

As noted in my last post, the disruption that may be triggered by the resumption of state "redeterminations" of Medicaid enrollees' eligibility, and subsequent disenrollment of some, is a focus of considerable angst -- and preparations, in states where Medicaid personnel are committed to keeping as many people insured as possible, to proceed with due deliberation and compassion. The Urban Institute has estimated that 15 million people may be disenrolled over the course of a year, the time period that CMS has asked states to devote to clearing the "redetermination" backlog. The Kaiser Family Foundation (KFF) estimates somewhat more modest losses, in a range from 5.3 million to 14.2 million.

This week the Census Bureau released its annual report on health insurance coverage in the United States. Based on the annual supplement to the Current Population Survey, the report shows a more modest increase in Medicaid enrollment from 2020 to 2021 -- 0.9% -- than CMS's administrative data would indicate.  According to CMS, Medicaid and CHIP enrollment increased by 6.6 million from December 2020 to December 2021. That's about 2% of the population.

The Census Bureau also released a second report, spotlighting health insurance changes over two years, and based on the American Community Survey. which interviews people throughout the year about their current insurance status (the CPS, conducted early in the year, asks respondents if they were insured at any point in the past year).  The ACS also shows a gap between Medicaid enrollment gains as reflected in administrative data compared to the survey data. According to the report, the percentage of the population insured by Medicaid increased by 1.3% over two years, from 2019 to 2021 (based, again, on surveys conducted throughout each year). The administrative data records an increase of 11.7 million enrollees from June 2019 to June 2021. That's about 3.5% of the population.

An analysis of the ACS data by KFF attempts to explain this gap. The explanation suggests to me that the disenrollments that will begin at the end of the PHE may not be as disruptive as "15 million disenrolled" might indicate -- at least in states that work in good faith and with due diligence to establish contact with all enrollees, accurately determine their status, and help them consider their options.  My emphasis via yellow highlight below (the bolded subhead is in the original):

Preparing for the great Medicaid unwinding: the case of New Jersey

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NJ FamilyCare end-of-PHE alert

The pending end of the Public Health Emergency declared by the federal government in March 2020 will trigger something of an earthquake among Medicaid enrollees.  

As of May of this year, enrollment in Medicaid and CHIP had increased by 18.3 million -- 26% -- since February 2020, the last month unaffected by the pandemic. Some 90 million Americans, well more than a quarter of the population, are now enrolled in Medicaid or CHIP.  That increase is mostly due to a moratorium on disenrollments enacted in March 2020 as part of the Families First Coronavirus Response act, which conditioned a 6.2% increase in the federal government's share of each state's Medicaid costs on implementing the moratorium (all states complied).  The Kaiser Family Foundation (KFF) estimates that 84% of the enrollment increase during the pandemic is attributable to the moratorium.

Viewing the uninsured rate through foggy lenses

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Snapshots of the health insurance status of the U.S. population are blurry.

When you look at the CMS tally of Medicaid enrollment increase since the pandemic struck, it seems, simply, that the increase swamps most estimates of the number of people that lost employer-sponsored insurance. Other factors are at work, of course. But the one large number is considerably larger than the other large number.

But official Medicaid enrollment totals may not be an entirely reliable measure of how many people are actually covered by Medicaid, and know themselves as such -- particularly during this pandemic, when disenrollments have been paused since March 2020. State Medicaid agencies are, to varying extents, blind beasts.

I know a young man who, during a year of transition, lived in two states and worked at three jobs, with a period of unemployment. At different points in the year he applied for Medicaid in two (blue) states and received rejection notices. From both of those states, months later (and months apart), while insured through a new employer, he was sent managed Medicaid membership cards and informed that he'd be enrolled since shortly after his application was completed.  In both states, it took some doing and some time to get himself disenrolled.

One quarter of the U.S. population is on Medicaid

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Time for an estimate of Medicaid enrollment growth since the eve of the pandemic, February 2020.  Monthly enrollment growth may finally be slowing, though it probably will not stop until the pause in disenrollments mandated by the Family First Act (passed in March 2020) is ended. Then, watch out: many states will probably commence income/eligibility checks at short intervals with a vengeance. 

As noted my previous update, the cumulative growth rate recorded in my sample, which is based on available monthly reports issued by the states, generally exceeds CMS's official tally (which lags this tally by four months) by about half a percentage point (state reports differ from CMS's official count in numerous ways).  Based on that rule of thumb, I would venture that enrollment nationally is up 16% since February 2020 and now stands at about 82.6 million for all full-service Medicaid programs. That's exactly one quarter of the U.S population. Exclude the undocumented and also legally present noncitizens who are time-barred from Medicaid eligibility, and the percentage is higher still.
[Update, 8/16/21: This estimate was high. The final tally for February is 81.4 million; CMS's total reported increase from Feb. 2020 through March 2021 is 15.6%. So my 34-state estimate is now coming in nearly a full percentage point ahead of final CMS tallies. CMS's preliminary March total is 81.7 million; the final March total will probably come in a bit over 82 million.]

At The American Prospect: Medicaid, the ACA's mainstay

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As in 2018, political warfare over healthcare -- now escalating in the wake of Ruth Bader Ginsburg's death -- is focused on "protection for people with pre-existing conditions." While the war of words focuses on rules governing the individual market for health insurance, which insures about 3% of the population, the real fight is over the extent to which the federal government will subsidize health insurance for those who lack access to employer-sponsored insures. The pre-existing condition that matters most is low income.

The main engine by which the ACA has reduced the uninsured population is Medicaid. Obscuring this fact distorts our political debate as well as federal and state government response to the pandemic.  I made that case in 2018 in USA Today, and today I've made it again in The American Prospect:

Medicaid enrollment in a pandemic: 18-state snapshot (expansion only)

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Update, 8/14: for all further updates please see the 26-state snapshot published August 12.

Update, 8/5/20:  Enrollment in Utah, which enacted full Medicaid expansion in Jan. 2020 following a partial expansion (for adults up to 100% FPL) launched in April 2019, increased 10.9% from February to June 2020. The population of enrollees rendered eligible by the expansion is up 25.5% in the same period. As the unemployed population in Utah was 45,000 higher in June than in February (largely recovered after a huge spike in April), the increase in Medicaid enrollees in the state since February (33,615) may exceed the increase in newly uninsured. 

Update, 8/4/20: Minnesota managed Medicaid/MinnesotaCare enrollment increased 1.5% July-August. It's now up 14.% since February. New York is up 9.5%, Feb-July; New Jersey is up 7.0% in the same period. Medicaid expansion population totals for Maine and Virginia are also update. 

Update, 8/2/20: I have updated the chart with July and/or June tallies for Illinois, Maryland, Oregon, and Washington. Noteworthy: a 3.1% surge in Illinois in June, and an Oregon update through July 27 that shows total enrollment up up 9.1% since February 3. Overall, enrollment in Medicaid programs charted by these 16 states (e.g., all Medicaid, managed Medicaid only, or ACA Medicaid expansion population only) was up 6.8% February through June. Colorado, newly added, was up 7.0%, Feb-June.

As mass unemployment appeared almost instantly in the wake of the pandemic-triggered shutdowns in March, and is likely to persist as the U.S. fails to contain the virus, I have focused almost all posts in recent weeks on increases in Medicaid enrollment in states that have enacted the ACA Medicaid expansion.

To repeat a baseline expectation, the Urban Institute forecast that if 15% unemployment lasts for "several months to a year," between 8.2 million and 14.3 million people would enroll in Medicaid, an increase of 11%--20% over total enrollment in early 2020, or 16%--28% over the total of enrollees under age 65.   While the current national unemployment rate has dipped officially to 11% (actually 12% when a categorization error acknowledged by BLS is added in), it's likely to spike again as our public health failures lead to renewed shutdowns and our legislative failures result in cutoffs or sharp reductions in relief benefits.

In Kentucky and Minnesota, Medicaid enrollment has already increased by double digits since February. In others, it's barely budged.  Myriad factors determine the rate of growth, including the extent of job losses in the state, the types of jobs lost, the mode/duration of layoff, and state per capita income.

I am more focused on factors within the states' control -- whether there is any effective outreach to inform the newly unemployed of their health insurance options and prompt them to apply -- for Medicaid (primarily) or marketplace insurance as appropriate.  Outreach can come via state-based ACA marketplaces (there are just 13; the federally administered HealthCare.gov serves the rest), advertising, governors' pandemic briefings, the state taxing authority (as in Maryland) or -- most promisingly, through the unemployment insurance division of state labor departments, as urged by Families USA and the Brookings Institute. As far as I know, Kentucky, where Medicaid enrollment is up 14%, is the only state that's fully exploiting this vital channel. Expanding presumptive eligibility (which Kentucky has also done) or accepting attestation of income can also have a strong impact.

Washington's ACA exchange gets its priorities straight

I have criticized state-based ACA exchanges for submerging information about Medicaid, which is likely to insure about twice as many of the newly uninsured as the ACA marketplace.

Scratch that complaint for Washington' state's HealthPlanFinder!  The home page has its priorities right, if the messaging is still a little fuzzy:

Apple Health is the state's Medicaid program, as you'll learn if you click on it. That click will bring you to a page that links to the eligibility requirements. For individual adults, they're clear and clean, paired with a prompt to apply:

"Anyone without health insurance can apply now" -- way to keep it simple, NYSOH

I have criticized messaging on ACA exchanges that's likely to confuse the majority of people newly uninsured after being laid off in the current crisis.  The main problem is that the exchanges submerge information about Medicaid, which is likely to insure more than twice as many newly uninsured people as is the ACA marketplace for private plans. Many who are eligible for Medicaid are likely never to find that out on the exchange websites.

Having obsessed about this a bit (1, 2, 3), I was pleased to encounter a Twitter ad from the New York ACA exchange, New York State of Health, that IMO gets the messaging right:

Anyone without health insurance can apply now thru #NYSOH. Enrollment is open for all NY State of Health Programs: Medicaid, Essential Plan, Child Health Plus and Qualified Health Plans. Find out what you qualify for by calling 1-855-355-5777 or visiting: https://t.co/v3Ojbz5NCV pic.twitter.com/97t8pPIDSU

— NY State of Health (@NYStateofHealth) June 26, 2020

In a crisis, Democrats bench the ACA marketplace

As tens of millions of American file for unemployment insurance, about half of those who lose job-based health insurance will be eligible for Medicaid and another 25-30% for ACA marketplace subsidies, according to estimates by the Urban Institute and Kaiser Family Foundation.

The lower percentage potentially picked up by the marketplace is not in itself a knock on that program.  In the U.S., regular unemployment insurance income is very low, and normally accessed only by a minority of the unemployed. In the 35 states that have enacted the ACA Medicaid expansion, those with incomes up to 138% of the Federal Poverty Level (FPL) are eligible for Medicaid. People whose current monthly income is below that threshold are expected to make up a large percentage of those losing job-based coverage.  The $600-per-week extra unemployment insurance (UI) benefit provided for up to four months by the CARES Act does not count toward Medicaid eligibility.

That said, the marketplace has always been a leaky vessel for those who need insurance and qualify for its subsidies (let alone those who need insurance and don't qualify for subsidies, a group that abandoned marketplace coverage in droves in response to the premium runups of 2017-18). A bit less than half of those who qualify for subsidies enroll, according to the Kaiser Family Foundation's 2019 estimate (which I suspect is a tad low). Takeup of Medicaid is much higher. The Kaiser Family Foundation's 2018 estimate of the uninsured who are eligible for Medicaid (6.7 million) is less than 10% of total Medicaid enrollment (73 million in 2018).

Going Japanese with Medicaid for the duration of the pandemic

As pandemic-triggered weekly job losses climbed into the millions and then tens of millions this spring, a cry went up among the healthcare-concerned on Twitter: now the catastrophic weakness of an employer-based health insurance system will hit home.

To which, a reasonable counter: what about Japan? The country has truly universal healthcare, and about 60% of the population is insured through employers. Almost all the rest are insured through residence-based plans run by local governments, including citizens' plans for the nonelderly, covering 27% of the population, and specialized plans for the elderly, covering 13%, according to the Commonwealth Fund. Those proportions are broadly similar to those of the U.S., leaving aside 10% of the U.S. population that was uninsured just prior to the pandemic.  In the U.S., about 54% of the insured population is covered by employer-sponsored plans, 22% by Medicaid, and 15% by Medicare.

Jon Walker has suggested that adapting Japanese model might provide the least disruptive route to universal coverage for the United States:

All adopting a Japanese type of system would require is for the U.S. to take what it is currently doing and heavily standardize it. The biggest change would be scrapping the individual non-employer-based market to put everyone on a government plan, but the individual market is the least popular part of our system anyway.

Americans, like the Japanese, have regionally-based government-run and financed health plans for the (mostly) non-elderly. They're known as Medicaid.*

Misinformation about Medicaid on state and federal websites

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In one of the many charming technical wrinkles that grace our healthcare system, the income threshold for Medicaid eligibility in states that have enacted the ACA Medicaid expansion (yes, long sentence, that's the point...) is 133% of the Federal Poverty Level (FPL)... except it's actually 138% FPL, thanks to a 5% deduction from an applicant's Modified Adjusted Gross Income (MAGI) mandated by the ACA.

Got that? Good. And who cares? What matters is the monthly income threshold in dollars for households of different sizes, against which people who think they may be eligible can check their income prior to deciding whether to apply.

Some government websites quote 133% FPL as the eligibility threshold for those rendered eligible by the ACA Medicaid expansion. That might not matter -- who knows what 133% FPL is? -- except that some state and federal sites take the trouble to convert that threshold to a monthly income. The wrong monthly income.

The elephant not in the room on ACA exchanges

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Here's the home page on the Maryland Health Connection, the state's ACA exchange. What's missing from this picture?

Covering the newly uninsured in New York: The BHP advantage

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My last post noted that Medicaid enrollment in New York spiked 2.6% in May and is up 4.2% since March. That's about mid-range among states for Medicaid enrollment growth since Covid-19 triggered mass layoffs.   Total enrollment in New York's mainstream managed Medicaid programs (about two thirds of total Medicaid enrollment in the state) increased by 177,858 from March to May, to 4,363,873.

New York's unemployment rate hit 14.5% in April. At 15% unemployment, the Urban Institute calculates that Medicaid enrollment in New York should eventually increase by between 641,000 and 1.1 million from pre-crisis levels, an increase of about 11-20%.  If a 4% increase as of May seems like a slow start, a new report by the United Hospital Fund analyzing Medicaid enrollment in New York during the Great Recession provides important context. 

From December 2007 to November 2009, as unemployment in New York more or less doubled from 4.8% to 8.9%, Medicaid enrollment increased by 10%, or 400,000. But Medicaid enrollment growth lagged behind job loss: "the fastest average increases in enrollment occurred approximately seven months after the fastest average increases in unemployment."*  

While Medicaid enrollment growth in New York so far seem modest compared to growth in Kentucky and Minnesota, the UHC report, citing growth in March and April, notes, "as the pandemic accelerated, Medicaid’s average monthly growth rate was four times as large as the average monthly growth rate during the Great Recession’s first twelve months."

Medicaid, moreover, is not the whole story. The Urban Institute estimates that approximately half as many of those who lose job-based insurance will find coverage in the ACA marketplace as in Medicaid. New York may do better than that, thanks to its Basic Health Program, the Essential Plan.

Wasting asset for insuring the newly uninsured: State unemployment insurance agencies

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I want to use my small megaphone to help call attention to a vital unused resource in the drive to connect millions of newly unemployed Americans to available subsidized health insurance: state unemployment insurance agencies.

The Brookings Institution put out an admirably clear briefing identifying the size of the target population and the steps state unemployment insurance (UI) agencies should take to inform those seeking unemployment benefits of their insurance options -- and ideally, to help them enroll. That report builds on a Families USA call to action spotlighting the almost total abdication of UI agencies on this front.

Just prior to the pandemic,  a pathetically small proportion of the unemployed (under 30%) accessed unemployment insurance. Historically, a similarly inadequate percentage of the newly unemployed found their way to health insurance within a few months. The ACA appreciably boosted the latter percentage, from 30% to 44%, according to Brookings. Transition from employer-sponsored insurance to Medicaid or marketplace is still missed by the majority.

In the current crisis, the Kaiser Family Foundation estimates that 79% of tens of millions of newly uninsured people will be eligible for either Medicaid (47%) or subsidized marketplace coverage (31%).  We have to do better than we've done historically to connect people to benefits for which they're eligible.