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caregiving responsibilities they had as well as the negative physical and mental impacts their <br />caregiving responsibilities had on themselves.165 <br />Treasury Response: Treasury agrees that these constitute impacts of the pandemic, and <br />accordingly, under the final rule, creating, expanding, or financially supporting paid sick, <br />medical, or family leave programs is an enumerated eligible use of funds to respond to the <br />negative economic impacts of the pandemic. <br />12. Health insurance. <br />Public Comment: Several commenters recommended that uses of funds to expand access <br />to health insurance be enumerated eligible uses; commenters believed that the heightened risk of <br />illness or hospitalization due to COVID-19 had increased the negative economic impacts of <br />lacking health insurance. <br />Background: In 2019, prior to the pandemic, it was estimated that 11 percent of <br />nonelderly adults lacked health insurance.166 By mid-2020, job loss had resulted in an estimated <br />3.3 million people losing their employer sponsored insurance, resulting in an additional 2 million <br />uninsured adults.167 Participation in Medicaid, the Children's Health Insurance Program (CHIP), <br />and the Affordable Care Act (ACA) marketplace played an important role in minimizing the <br />number of people who completely lost health insurance during the early phases of the pandemic; <br />165 Id. <br />166 Jennifer Tolbert et al., Key Facts about the Uninsured Population, Kaiser Family Foundation (November 6, <br />2020), https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/. <br />167 Joshua Aarons et. al., As the COVID-19 Recession Extended into the Summer of 2020, More Than 3 Million <br />Adults Lost Employer -Sponsored Health Insurance Coverage and 2 Million Became Uninsured, Urban Institute <br />(September 18, 2020), https://www.urban.org/research/publication/covid-19-recession-extended-summer-2020- <br />more-3-million-adults-lost-employer-sponsored-health-insurance-coverage-and-2-million-became-uninsured. <br />112 <br />