In August, 4,967 people were unemployed in Columbia, nearly double the number of August 2019, according to the U.S. Bureau of Labor Statistics.

As people have lost work, they’ve also lost their health insurance coverage. In Missouri, where 52% of Missourians are insured through their employer, according to the Kaiser Family Foundation, that translates into an estimated 1,238 newly uninsured in Columbia.

“Losing insurance, and by extension your access to health care, during a pandemic adds layers of stress and anxiety to a situation that is difficult to handle at any time,” Dina van der Zalm, a health care organizer at the Missouri Rural Crisis Center, said via email.

“Across Missouri, and the nation, we see people delaying access to needed care, be that COVID testing, emergency care or even needed routine care to manage chronic conditions,” she said. “That is motivated by two layers, the now unaffordable cost and then the layered concern of exposure to COVID, knowing the illness could also carry a hefty medical bill.”

Jeanne Kelley, 53, from Columbia recently lost her job of 20 years. Luckily, her job will continue to pay her for a few more weeks, but after that she will have to go on unemployment.

“It’s not hitting me in the money part yet, but I know my time’s ticking,” Kelley said. “If I don’t get a job, there goes my medical insurance and my pay. It’s pretty hard to find now.”

Kelley said she is worried about the risks of COVID-19 infection as she looks for a job or starts at a new workplace.

“I’m just hoping things work out ...” Kelley said. “But if I have medical problems, I’ll have to go to the Family Health Center. What else can I do?”

Van der Zalm said as the number of uninsured people increases through job loss, many uninsured people “wait out” their uninsured time with the hope they will be able to find a job soon.

A study by the Commonwealth Fund found an estimated 14.6 million people lost health insurance due to the pandemic, including dependents who rely on workers for health insurance.

“We are seeing, both in Missouri and nationwide, a drop in how many people are insured,” said Nancy Kelley (no relation to Jeanne Kelley), lead strategist in initiatives at the Missouri Foundation for Health. “It’s really disappointing in terms of the progress that’s been made.”

If employees are just temporarily furloughed, they are not likely to lose their insurance. According to a Commonwealth Fund survey, more than half of workers who temporarily lost their job still had health insurance coverage through their employer.

However, six months into the pandemic, many employees who expected to be called back to work are facing permanent unemployment as workplaces go out of business or can’t afford to keep the previous number of employees on payroll.

“When you take it down to the personal level, when people don’t have that safety net under them, with health insurance, they aren’t able to get the medication that they need, maybe they aren’t able to afford care, and then if there is an emergency of any type ...,” Nancy Kelley said. “You hate to have anyone have to make that choice between getting the medical care that they need and making the choice not to because they know that they can’t afford it.”

Although Missouri voters approved an amendment in August that will allow Missouri to expand Medicaid, the expansion will not take effect until July 2021.

“The pandemic really laid bare how ill-prepared our health care system is to support people without insurance (which has long been true, but was not always in the spotlight),” Van der Zalm said. “It also made crystal clear how much our health as a community and state is dependent on the health of everyone, not just those who can afford it or have the best insurance.”

In July, people aged 19 to 65 with an income that does not exceed 138% of the poverty level will be eligible for Medicaid coverage. In Columbia, that means single adults with an income of $17,609 or a household of four with an income of $36,156 will be eligible.

“We really encourage people to check out all of their options,” Nancy Kelley said.

She acknowledged that it can be confusing but said: “There is help available.”

People can receive free, certified assistance finding the right health insurance plan at 800-466-3213 or online at

  • Public Life reporter, fall 2020. I am currently studying investigative journalism and political science. Reach me at gaap8b@mail.missouri,edu, or in the newsroom at 882-5700.

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