Natural disasters make people more likely to get health insurance, study finds

A new study by researchers at the University of Louisiana at Lafayette and Louisiana State University looked at a less explored aspect of the relationship between disasters and insurance: health insurance.

What they found might help inform the way we think about disasters from a health care perspective and help shape the way government agencies approach survivors in the aftermath of a storm or flood.

Looking at health care data collected by the researchers themselves for over a decade as part of the Louisiana Health Insurance Survey in combination with data on disaster collected by the Federal Emergency Management Agency (FEMA), the group found that there was a slight increase in the rate of insured persons among those who had suffered a loss from several hurricanes and a flood that happened between 2005 and 2017.

"The impacts of a disaster can ripple much further, and kind of permeate people's way of thinking beyond and outside of the exact types of risks they might have seen in that event," Stephen Barnes, founding director of the Kathleen Babineaux Blanco Public Policy Center at UL and one of the paper's authors, explained.

"We know that part of that decision making is kind of a rational calculation of how likely might I be to face certain types of damage or risk," Barnes said of people's increased likelihood of purchasing insurance in general after a disaster. "When people have lived through a traumatic experience like this they may have a heightened sensitivity to risk."

Another reason there may be higher enrollment rates in health insurance following a disaster is the workforce crunch that has followed events like Hurricane Katrina, one of the first storms whose impacts were included in the study.

Increased workforce needs during the recovery process and the lack of available workers caused by displacement might lead employers to offer more competitive benefit packages, including health insurance, the researchers theorized. Recovery also brings with it temporary positions with responding state agencies, which usually feature health insurance.

Public health expert Mikal Giancola was one of those workers who came to New Orleans to assist in the recovery process post-Katrina as an outreach supervisor for the Louisiana Department of Health — and received health insurance in the process.

"There was a huge swell of post-Katrina jobs," Giancola said, adding that the arrival of aid workers likely has something to do with the increase in insured persons.

Then there's the broad variety of disaster-related health issues, such as psychological and physical trauma, heart and blood pressure issues due to stress, and pregnancy complications.

"I have friends who very much feel like they've lost family members for that specific reason," Giancola said of heart issues caused by disaster-related stress.

Visits to the emergency room and appointments to enroll in disaster benefits might be another way disaster survivors get connected to healthcare options they may not have previously been enrolled in, specifically the government-funded Medicaid and Medicare programs, Giancola suggested.

For Stephens and his colleagues, this initial study is a starting point they hope can lead to more research on the subject and have an impact on public policy.

"This was really our first effort to try to dig into this specific question," Barnes said. "It's something that we do hope to come back and explore more fully."

While the group did not provide any specific policy suggestions, Barnes said he hopes that state officials will find value in the study's results.

"We hope this will help us to even better understand how disasters like these impact people's lives, and ways in which we can design public institutions to try to minimize those negative effects and generate better outcomes after events like that," Barnes said.

Although no longer associated with a government agency, Giancola said the results of the group's research may suggest an opportunity for public officials to improve those post-disaster health outcomes. "As a public health professional, I would be interested in ensuring that when we have swells in insured persons that they're getting their preventive screenings and preventive care," he said.