It is almost always the case that when disaster strikes, people living in poverty are often affected disproportionately. A lack of resources limit both these families’ ability to prepare for emergencies and their ability to recover. As the novel coronavirus spreads across the country and more Americans are contracting COVID-19, we can expect that low-income Americans will be hit especially hard.
Here are some of the ways in which low-income people may be disproportionately impacted:
Poor Americans are much more likely to be uninsured, and as a result, much less likely to receive medical care. Without regular medical care, they are more likely to have underlying health conditions that may make them more susceptible to the worst effects of COVID-19, resulting in a higher mortality rate. Even without underlying medical conditions, the inability to afford health care may keep some from receiving treatment, exacerbating symptoms, and perhaps even prolonging the course of the disease. The problems caused by lack of health coverage are especially a problem for states like Missouri that have not expanded Medicaid.
Those without health insurance may also be less likely to get tested when they exhibit symptoms, and therefore may not know that they have been infected with the coronavirus. Some could unwittingly be passing on the virus, meaning that a lack of insurance coverage is a health threat for everyone.
With little or no money to spare, low-income people are less able to stock up in anticipation of quarantines or travel restrictions.
Since low-wage workers are disproportionately employed in industries that are most likely to experience some of the most severe effects of restrictions on travel and measures to encourage social distancing (restaurants and hotels, for example), these individuals are the most likely to experience unemployment resulting from the spread of the virus and measures to control it.
Necessary measures intended to limit the spread of the virus, such as social distancing, may also harm poor people. If workers are forced to stay away from work temporarily, low-wage jobs are the most likely to involve tasks that cannot be done at home. In fact, these jobs, which often involve caregiving and customer service, are more likely to involve direct human contact than most higher wage jobs. For those low-wage workers who do have jobs that are amenable to working remotely, they still may not be able to do so because they are less likely to have access to broadband Internet connections. Since low-wage jobs rarely include paid leave, these workers are faced with the prospect of long periods of lost income whether or not they actually contract COVID-19.
Given the outsized impact low-income people will endure, Missouri CAN urges both employers and policymakers to consider these burdens and take steps to lessen the impact on low-income Missourians. These steps should include the following:
Extend health coverage so low-income Missourians can receive testing and treatment they need. Tests should be provided for anyone free of charge. Congress should make more Medicaid funding available and grant waivers to states to ensure that Medicaid covers the cost of treatment.
Additional nutrition assistance, through measures like temporary increases in SNAP (Supplemental Nutrition Assistance Program) benefits, is needed to address the increased food insecurity that many families will face.
The federal government should provide additional funds for states to extend unemployment insurance benefits, and states should be prepared to extend the period of eligibility these benefits. Work requirements should be relaxed, especially for infected or high-risk individuals.
Employers should provide paid leave for workers unable to work due to illness, quarantine, or temporary closure of workplaces. The federal government should provide funds to assist small employers make this leave available.
In addition, Missouri CAN joins advocacy organizations around the state in asking the U.S. Senate to ensure passage of the House version of the Coronavirus Response Act, though we realize some modifications may be necessary. The FMAP (Federal Medical Assistance Percentages) increase included in the Act are among its most important provisions because FMAP:
Allows states to address immediate public health needs – By providing immediate resources to states as they try to cover large, unexpected COVID-19 related costs, it will prevent states from shortchanging critical public health measures – from hospital readiness to public outreach to quarantine-related costs – because they don’t have enough funds. By covering a larger share of Medicaid costs, the proposal frees up state resources for other immediate health-related needs.
Makes it possible for states to use Medicaid to cover COVID-19 related needs – Medicaid provides a wide range of flexibilities states can use to help address the crisis, from targeted eligibility expansions to insure people can get tested and treated to broadening coverage of telehealth to covering certain quarantine-related costs, as Washington state is seeking to do. But exercising these options costs money. A broad increase in federal Medicaid funding is the best way to help state policymakers make the targeted Medicaid changes and adjustments that meet their states’ needs.
Prevents states from cutting Medicaid eligibility or benefits during the public health crisis – Past experience shows that, without federal action, state policymakers (constrained by balanced budget requirements) will restrict access to Medicaid over the coming months, as unexpected costs from COVID-19 mount and if, as seems increasingly likely, an economic downturn reduces state revenues. That would lead more people to become uninsured in the middle of the coronavirus crisis, undermining the public health response and creating immense hardship for families. The proposal prevents this both by providing states with more resources and by requiring states accepting these resources to agree not to cut Medicaid eligibility for the duration of the public health emergency.
Provides needed support to the economy – With an economic downturn likely as a result of coronavirus, state budget cuts would also damage the economy by further contracting demand. Research on the similar FMAP increase put in place in 2009 found that it provided highly effective economic help. The policy was also effective in preventing state budget cuts when adopted on a bipartisan basis as part of 2003 economic recovery legislation.
