As the COVID-19 pandemic unfolds, the United States confronts a public health crisis surpassing anything experienced in the last century. Beyond the immediate challenges of caring for those afflicted with the virus, the extraordinary social distancing required to fight the pandemic has also triggered a dramatic economic slowdown, with the unemployment rate at its highest level since the Great Depression and tens of millions filing for unemployment benefits. Many unemployed New Yorkers are turning to Medicaid, which provides a health coverage safety net for low-income individuals. Medicaid enrollment is "countercyclical": it rises during periods of increased unemployment, with individuals enrolling after they have lost employer-sponsored insurance and their incomes have fallen below Medicaid's eligibility thresholds. To help policymakers and stakeholders understand what to anticipate in the current downturn, this brief examines the timing and magnitude of New York's Medicaid enrollment growth during the "Great Recession" of 2007-2009 and describes how state and federal policies facilitated that growth. The brief also compares those historical policy changes to state and federal actions taken during the current crisis--while acknowledging the unprecedented ways in which COVID-19 is shaping Medicaid's response to rising unemployment and New Yorkers' need for coverage.
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