August 3, 2020

Jana Plat
(202) 861-1270

Washington, DC — Today, Business Forward issued a report explaining how the Affordable Care Act (ACA) and Medicaid could provide critical support to families that lose their employer sponsored healthcare. The Safety Net We Need argues Congress and the Trump Administration should be making it easier for families affected by layoffs to enroll in the ACA or Medicaid. Instead, they are making it harder — all while suing to overturn the ACA altogether. 

Healthcare industry experts predict 27 million Americans could lose their employer-sponsored health insurance due to Covid-19-related layoffs. The good news? Eight in 10 of these Americans would be eligible to switch to coverage under the ACA or Medicaid. 

“The Affordable Care Act is working,” explained Jim Doyle, President of Business Forward. “More than 20 million Americans have enrolled; its market-based reforms have slowed health care spending; and it could serve as a safety net for workers laid off because of Covid-19. ”

In spite of the large numbers of Americans losing their health insurance, the Trump Administration has made it harder to enroll in the ACA by reducing federal funding for enrollment outreach and assistance — and by refusing to extend enrollment periods. The Trump Administration and 18 Republican state attorneys general also filed a lawsuit to overturn the ACA entirely. If successful, this could cause 19 million Americans to lose their health insurance. 

For recently unemployed Americans living in any of the 13 states with Republican governors who have not expanded Medicaid, affordable health care is even more limited. In those states, there exists a ‘coverage gap’ that affects Americans making above the state’s Medicaid threshold but below the federal poverty line – at which point ACA marketplace subsidies normally kick in. 

“The Trump Administration should be working with Republican governors to help the 2.6 million Americans stuck in the Medicaid coverage gap, particularly now, when another 1.9 million Americans affected by Covid-19 layoffs could soon join them,” said Doyle. 

The topline:

1. Covid-19 layoffs have put 27 million Americans at risk of losing their employer-sponsored health insurance (“ESI”). Fortunately, 8 out of 10 of them are eligible for coverage under the Affordable Care Act or Medicaid.

2. The Trump Administration should be helping Americans make this switch. It should also be working with Republican governors in 13 states that have yet to eliminate a gap in their states’ Medicaid coverage. Closing that gap could insure another 4.5 million Americans.

3. Instead, the Trump Administration has gutted programs that help Americans enroll in the ACA by 80-90%. In March, it refused to re-open ACA enrollment periods for workers laid off due to Covid-19.

4. The Trump Administration has also filed a lawsuit to overturn the ACA entirely, including premium subsidies, Medicaid expansion, and protections for preexisting conditions. It has presented no plan to replace the ACA.

5. Despite obstruction from Republicans in Congress, the ACA is working. More than 20 million Americans have enrolled, and the market-based reforms have helped slow healthcare spending for Medicaid by 21.5%, Medicare by 18.2% and private health insurance by 6.1% (compared to projections made pre-ACA). 



With the help of more than 60 of America’s most respected companies, Business Forward is making it easier for more than 100,000 business leaders from across America to advise Washington on how to create jobs and accelerate our economy. Business Forward is active in over 125 cities and has worked with more than 650 mayors, governors, members of Congress, and senior Administration officials.

Business leaders who have participated in our briefings have seen their suggestions implemented in the Affordable Care Act, the JOBS Act, the Clean Power Plan, the Toxic Substances Control Act, presidential budgets, and three trade agreements. Many have also shared their recommendations with their representatives in Congress and through phone calls, op-eds, and interviews with local media. Ninety-eight out of 100 business leaders who have participated in a Business Forward briefing would be interested in participating in another one.