It’s been more than one year since COVID-19 appeared, yet families across the nation and the U.S. health care system are still straining under the weight of yet another surge in cases. While vaccine testing, development and even administration are underway, it is still difficult to imagine our daily lives, health care system and economy returning to “normal” anytime soon.
Though Congress passed a relief package to aid a struggling nation, countless families still find themselves on the verge of losing their homes due to an eviction crisis. As organizations working to improve health for underserved communities, we see firsthand how a lack of access to essential needs like housing jeopardizes health.
This means that the housing crisis we are currently in due to COVID-19 and the potentially greater one on our doorstep will continue to put added pressure on the health care system in the immediate, and for years to come.
However, the pandemic has largely left one key health care stakeholder in a strong position to help people with housing, should they choose to – health insurers.
At the outset of the pandemic, insurers were largely unconcerned that the virus would impact their bottom line. The good news for them and their shareholders is that, even with a dip in Q4, this has more or less been the case. Insurers’ 2020 earnings paint a rosy picture. UnitedHealth Group reported $15.4 billion in profit; Cigna – $8.5 billion; CVS Health – $7.1 billion; Anthem – $4.6 billion. Even nonprofit insurers like Blue Cross Blue Shield have had to offer rebates in multiple states to meet federal obligations.
These earnings should not be a boon solely to shareholders. They can be used to benefit people enrolled in these plans whose lack of stable, affordable housing contributes to poor health outcomes and increased costs. Instead of paying to treat the symptoms of a broken system, it is time that insurers do more to support their customers’ well-being by helping them to stay healthy.
Health plan investment in affordable housing is not unprecedented. Insurers like Kaiser Permanente, UPMC, CareOregon and UnitedHealth have invested in affordable housing, illustrating that health plans understand the link between housing and health and their role in addressing it. As UnitedHealthcare CEO Steve Nelson has said, “Access to safe and affordable housing is one of the greatest obstacles to better health…” But dipping a toe in the water is not sufficient – insurers need to dive in.
Investment in housing by health insurers could be more significant given the billions of dollars in earning they generate. Insurers could easily invest – with the expectation of financial return – some portion of their substantial treasuries without any significant effect on their financial health and solvency. States such as California and Massachusetts have even helped to facilitate these kinds of investments.
Moreover, this is not only a matter of financial interest, it is a moral and ethical one as well.
Insurers have come out with numerous statements affirming their desire to address their role in the historic, structural racism embedded into our nation’s foundation. And insurers should certainly understand how institutional racism affects the health of their members.
We know that Black and brown people experience greater obstacles to accessing safe and secure housing, either from historically racist power structures or lack of equal economic opportunity. This has contributed to generations of destabilization for Black and brown communities and a systemic denial of economic opportunity, equal education and access to quality health care.
Housing is a critical factor contributing to disproportionate health outcomes when it comes to COVID-19. But Black and brown people also experience disparate outcomes when dealing with health systems and providers outside of a pandemic. This takes the form of higher rates of uninsurance, greater infant and maternal mortality rates, poorer oral health, and greater incidence and death from diseases like cancer and heart disease. These are just a few of the myriad poor health outcomes that are exacerbated by a lack of access to stable housing.
If we want to mitigate the current and future impacts of COVID-19 and continue to address generations’ worth of poor health outcomes, one the best things that we as a nation can do is to make meaningful investments in housing.
If we take insurers at their word – that they are committed to mitigating the effects of COVID-19, addressing racial inequities and keeping people healthy, then making investments to preserve and build better, more affordable housing is one of the best paths forward.
Emily Stewart is the executive director of Community Catalyst, the largest national consumer health advocacy organization in the country. Chris Kabel is a senior fellow with Kresge’s Health Program.