Access and enrollment in safety net programs in the wake of COVID-19: A national crosssectional survey

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations


The global COVID-19 pandemic is causing unprecedented job loss and financial strain. It is unclear how those most directly experiencing economic impacts may seek assistance from disparate safety net programs. To identify self-reported economic hardship and enrollment in major safety net programs before and early in the COVID-19 pandemic, we compared individuals with COVID-19 related employment or earnings reduction with other individuals. We created a set of questions related to COVID-19 economic impact that was added to a cross-sectional, nationally representative online survey of American adults (age ≥18, English-speaking) in the AmeriSpeak panel fielded from April 23-27, 2020. All analyses were weighted to account for survey non-response and known oversampling probabilities. We calculated unadjusted bivariate differences, comparing people with and without COVID- 19 employment and earnings reductions with other individuals. Our study looked primarily at awareness and enrollment in seven major safety net programs before and since the pandemic (Medicaid, health insurance marketplaces/exchanges, unemployment insurance, food pantries/free meals, housing/renters assistance, SNAP, and TANF). Overall, 28.1% of all individuals experienced an employment reduction (job loss or reduced earnings). Prior to the pandemic, 39.0% of the sample was enrolled in ≥1 safety net program, and 50.0% of individuals who subsequently experienced COVID-19 employment reduction were enrolled in at least one safety net program. Those who experienced COVID-19 employment reduction versus those who did not were significantly more likely to have applied or enrolled in ≥1 program (45.9% versus 11.7%, p<0.001) and also significantly more likely to specifically have enrolled in unemployment insurance (29.4% versus 5.4%, p < .001) and SNAP (16.8% versus 2.8%, p = 0.028). The economic devastation from COVID-19 increases the importance of a robust safety net.

Original languageEnglish (US)
Article numbere0240080
JournalPloS one
Issue number10
StatePublished - Oct 2020

Bibliographical note

Publisher Copyright:
© 2020 Saloner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


  • Adolescent
  • Adult
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections/economics
  • Cross-Sectional Studies
  • Family Characteristics
  • Female
  • Food Assistance
  • Health Insurance Exchanges
  • Health Services Accessibility
  • Housing/economics
  • Humans
  • Male
  • Medicaid
  • Middle Aged
  • Pandemics/economics
  • Pneumonia, Viral/economics
  • SARS-CoV-2
  • Safety-net Providers
  • Surveys and Questionnaires
  • Unemployment
  • United States/epidemiology
  • Young Adult

PubMed: MeSH publication types

  • Journal Article


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