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People in 533 counties in the United States have two big problems, a Center for Public Integrity analysis found: They’re more likely to work in leisure and hospitality jobs decimated by the COVID-19 crisis than the national average, and before the crisis were less likely to have health insurance. Now, millions in these counties are out of work and in danger of losing employer-provided health care, threatening to add to already higher-than-average rates of uninsured.

The problem is especially acute in 14 states that chose not to expand Medicaid. 

African Americans, Hispanics and Native Americans are less likely to have insurance and more likely to live in places where fewer residents do. Leisure and hospitality jobs — in restaurants, hotels and other businesses heavily impacted by the pandemic — are more likely to employ Hispanic workers and pay wages below the national average, leaving those workers more exposed to the economic headwinds of the crisis as officials shutter non-essential businesses and tourism tumbles.

Nationally, more than 27 million Americans lacked health insurance before the crisis; more than 20 million workers have filed claims for unemployment since it began.

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