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Texas has the highest uninsured rate in the U.S. And during the pandemic, an estimated 659,000 Texans lost their health care.

Montanique DeShay stops by the newly opened MedSpring Urgent Care clinic on South Lamar Boulevard and Barton Springs Road in Austin to have her annual physical so that she can play sports at school this year on Aug. 27, 2014. With the increase of urgent care clinics in large cities, which offer treatment for common illnesses, hospitals are losing insured patients to these type of walk-in clinics and facing increased uncompensated care costs for their uninsured patients who can't pay out of pocket for urgent care outside of an emergency room.       Martin do Nascimento for the Texas Tribune
Montanique DeShay stops by the newly opened MedSpring Urgent Care clinic on South Lamar Boulevard and Barton Springs Road in Austin to have her annual physical so that she can play sports at school this year on Aug. 27, 2014. With the increase of urgent care clinics in large cities, which offer treatment for common illnesses, hospitals are losing insured patients to these type of walk-in clinics and facing increased uncompensated care costs for their uninsured patients who can't pay out of pocket for urgent care outside of an emergency room. Martin do Nascimento for the Texas Tribune

Job loss stemming from the coronavirus has stripped health insurance from an estimated 659,000 Texans between February and May, according to a new study.

The analysis, published Tuesday by Families USA, a nonpartisan consumer advocacy group, found that 5.4 million laid-off workers have lost their health insurance across the country from February to March.

The report called the past few months the “deepest economic crash since World War II,” adding that job loss from the pandemic has left more people uninsured than ever recorded. The increase in uninsured Americans this spring is 39% higher than the previous record, set during the Great Recession of 2008 and 2009, when 3.9 million adults under the age of 65 lost insurance.

In Texas, 29% of adults under 65 — about 4.9 million people — were estimated to be without health insurance in May 2020, the highest uninsured rate of all states. In 2018, a quarter of adults under 65 were uninsured in Texas.

Since mid-March, nearly 2.8 million people have filed for unemployment benefits in Texas. The state’s unemployment rate hit an all-time high of 13.5% in April, according to the U.S. Bureau of Labor Statistics. In May, the unemployment rate fell slightly to 13%, as businesses reopened. The rate for June is to be published this week.

Texas is among a minority of states that have declined to expand Medicaid coverage to people with incomes near or below the poverty line, leaving fewer options to adults who lose their job-based health insurance.

Countrywide, almost half of the health care coverage losses because of the pandemic happened in five states, which make about 36% of the total U.S. population: California, Texas, Florida, New York and North Carolina.

Many states with higher increases in uninsured people are also experiencing fast surges in COVID-19 cases: Arizona, Florida, Louisiana, South Carolina, Georgia and Mississippi.

Another study from the Kaiser Family Foundation had estimated that the figure could be higher: as many as 1.6 million Texans have likely lost their employer-sponsored insurance since the start of the pandemic, when considering all ages, as well as family members of the newly uninsured. The same foundation estimated that countrywide, 27 million Americans have lost their coverage since the pandemic started in April.

The Robert Wood Johnson Foundation projects that by December 2020 more than 10 million people in the U.S. will have lost their health insurance as a result of losing their job, some of them regaining coverage through Medicaid or a family member’s policy.

Despite these variations, those studies all agree that more people are living without health insurance than ever recorded, during a time when access to health care has become more critical than ever.

Public health experts, doctors and elected officials have warned that the lack of health care coverage for millions of Americans could complicate efforts to contain the disease. At the beginning of March, more than 800 scientists, doctors and lawyers wrote an open letter to the Trump administration, saying it would be “critical for policymakers to ensure comprehensive and affordable access to testing, including for the uninsured.”

To be uninsured for adults is “increasing the odds that, if they contract COVID-19, delays in diagnosis and treatment could endanger both them and their communities,” Families USA wrote in the report. In the U.S. 14% adults say they would avoid seeking healthcare for a fever or dry cough — symptoms of COVID-19 — due to concerns about their ability to pay for it, the group said, citing an April Gallup poll.

In Texas, Hispanic people are the most likely to lack health coverage, making up 61% of the uninsured but only 40% of the population, according to figures used by the Texas Medical Association.

National data has shown that Black and Hispanic people are disproportionately affected by the virus. Texas data remains incomplete but city and county-level analysis indicates it could be playing out similarly in some communities. In Dallas, over 60% of overall COVID-19 cases to date have been Hispanic. Harris County reports that Hispanics make up 42% of the people who have tested positive and for who information about race was collected.