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Official estimates of deaths attributable to COVID-19 indicate that over 1 million Americans have lost their lives to COVID-19 since the first COVID-19 death was reported in the United States in March 2020.  However, this staggering loss does not include any deaths caused by COVID-19 that were attributed to other causes. In addition, it does not include deaths that were indirectly the result of the pandemic but not caused by COVID-19 directly. For example, some people may have been unable to access prevention and treatment for other health conditions during the pandemic, leading to higher-than-expected mortality. Deaths may also have been averted during the pandemic due to, for example, lower risks of accidents or injuries as a result of pandemic-related mitigation measures.

This brief investigates how excess mortality varies across States and examines the role of health insurance coverage in explaining these differences. The evidence shows that lack of health insurance coverage is associated with higher excess mortality rates during the pandemic, even after controlling for differences in vaccination rates, the age distribution of the State, the share of the State population with pre-existing conditions, and the degree of each State’s restrictions during the pandemic. The findings suggest that lack of health insurance coverage may have generated more excess deaths in States with relatively low coverage rates. . . .


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