The U.S. Health Insurance System

COVID-19 sparked a recession and massive job cuts, which have cost millions of people their health insurance. An estimated 160 million Americans had insurance through an employer before the pandemic, and as many as 43 million may lose their coverage. The dramatic change could upend the U.S. employer-based health insurance system, as more people join government programs such as Medicaid or use tax subsidies to buy plans on Obamacare exchanges. But a contentious election campaign, in which health care has become an even more prominent issue due to the pandemic, could also alter the long-term outlook for health insurance in the United States. Democratic presidential nominee Joe Biden supports adding a public option to the Obamacare law, and liberals may push for a government-run single-payer system if the Democrats win big gains in the election. At the same time, Obamacare could face a significant threat in November when a conservative-dominated Supreme Court hears a new challenge to the law.