![]() ![]() People who are eligible for SSDI become eligible for Medicare after a 2-year waiting period and people who are eligible for SSI are generally eligible for Medicaid. If people with long COVID quality for federal disability programs, more people will have publicly funded health insurance through Medicare and Medicaid. At this point, it is unclear how many people with long COVID will qualify for disability benefits under this definition. Despite the recognition that long COVID can be a disability, to qualify for federal programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), applicants must be unable to work and have health conditions that last for at least one year or result in death. Department of Health and Human Services determined that long COVID can be a disability under the Americans with Disabilities Act if an individual assessment determines that it substantially limits one or more major life activities. The Office of Civil Rights within the U.S. Those with high medical spending could qualify for Medicaid through medically needy programs.Īn important question for the future is whether federal disability programs will count long COVID as a disability. ![]() Others could newly qualify for Medicaid – though eligibility is more limited in the dozen states that have not expanded the program under the ACA. Some could newly qualify for help paying for private health insurance through the ACA marketplaces. People who are no longer able to work could eventually lose their existing coverage and would also experience loss of income. Changes in employment would therefore have significant effects on people’s sources of health insurance. Over 60% of working-age adults have their health insurance coverage through an employer. There may be significant changes in health coverage associated with long COVID. It is also unclear how employment consequences will be spread across industries, but some industries are likely to be disproportionately affected-particularly those with higher rates of initial infection, such as health care. It is unclear how long-term these challenges will be and whether health insurance spending will rise because of long COVID. Those higher claims could increase costs for insurers and eventually, employers. It is too early to have comprehensive data or a clear picture of employment outcomes but there are reports that claims associated with long COVID are rising for disability insurance, workers compensation, and group health insurance. If we conservatively assume 100 million working age adults have been infected, that implies 10 to 33 million may have long COVID. The prevalence of long COVID is equally uncertain with studies finding that the percentage of working age adults with COVID who develop long COVID could be 10 percent, 20 percent, or 33 percent. Also unknown is how long people with long COVID will remain ill, although one study reported that 29 percent of long COVID patients had self-reported symptoms for more than one year. It is a new phenomenon and the ICD-10 code to identify medical claims only became available in October 2021. There is no standard presentation of or treatment for long COVID. Patients report a wide range of physical and mental health conditions including malaise, fatigue, breathing challenges, cardiovascular abnormalities, migraines, and mental health impairments. Long COVID is not a single condition but rather “a wide range of new, returning, or ongoing health problems that people experience after first being infected with the virus that causes COVID-19,” according to the CDC. Long COVID involves a range of potentially disabling symptoms and may affect 10 to 33 million working-age adults in the United States (Figure 1). ![]() One study of the VA health system found that the risks of long COVID increased with each subsequent reinfection. Vaccines and prior immunity protect against severe illness and death, but it is unclear whether they protect against long COVID. The newest subvariant- BA.5- readily infects the vaccinated and people with prior immunity. The numbers are already daunting and infections continue to rise. We continue to follow the research on who is most at risk of long COVID and whether there are interventions that can reduce its incidence, length, or severity. This policy watch reviews what we know and outlines key questions to watch for regarding employment and coverage outcomes. Long COVID has been described as our “ next national health disaster” and the “ pandemic after the pandemic,” but we know little about how many people are affected, how long it will last for those affected, and how it could change employment and health coverage landscapes. ![]()
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