3 in 4 U.S. adults who lost their job sometime in 2010 had medical bill problems, from having problems paying the bill to changing their way of life in order to pay that bill.
This is the rationale for health reform –the Affordable Care Act (ACA) — notes the August 2011 paper from The Commonwealth Fund, Realizing Health Reform’s Potential.
The stats are easy to understand: in July 2011, nearly 14 million U.S. residents were out of work, on average for over 40 weeks. A job loss led to health-uninsured status for some 9 million health citizens between 2008-2010, 3 in 4 of whom did not get health care or fill an Rx because of the cost.
CMWF’s 2010 biennial health insurance survey found that 60% of adults under 65 who looked for individual health insurance coverage found it impossible or very difficult to find a health plan they could afford. If these people could identify a plan they wanted, 35% were rejected by the health plan, charged a higher price, or had an exclusion of an existing health problem. Thus, the proportion of under-65s in the U.S. with individual health plans has declined, from 5.7% in 1997 to 4.2% in 2009.
The “potential” that the ACA affords U.S. adults who are uninsured has to do with 2 key line items:
- Coverage for people with pre-existing conditions, and
- Near-universal coverage in 2014, when the ACA is implemented, through Medicaid, CHIP, a Basic Health Plan from the state of residence, or subsidized private health coverage via the new state health insurance exchanges.
The Fund also points out that the costs of COBRA, which is meant to ‘bridge’ unemployed, uninsured workers between jobs, should be further subsidized for people who fall through coverage cracks between ‘now’ and 2014 because of the high cost of COBRA for people without a regular source of income. The lagging economy exacerbates the depth and breadth of that ‘crack.’
Health Populi’s Hot Points: I observed the out-of-reach cost of COBRA for the unemployed in Health Populi in the post, The average COBRA payment costs 84% of average unemployment benefits. In 2009, I wrote, “the average unemployment benefit across the U.S. is $1,278; COBRA monthly premiums for family coverage are $1,069. In 9 of the 50 states, COBRA equals or is greater than the monthly unemployment benefit. Those states are Alaska, Arkansas, Arizona, Delaware, Florida, Louisiana, Mississippi, South Carolina, and West Virginia. These metrics are shown in the table.”
The Commonwealth Fund’s policy recommendation is even timelier in mid-2011, with the recession lingering in most job markets. It will be a long, costly interim between mid-2011 and the start of 2014 for people who remain jobless and uninsured without policymakers in Washington DC revisiting the cost of COBRA…and soon.
Jane Sarasohn-Kahn is a health economist and management consultant that serves clients at the intersection of health and technology. 
[...] and unemployment insurance payments, the latter of which often can’t cover the former (see this post describing that financial [...]
[...] COBRA and unemployment insurance payments, the latter of which often can’t cover the former (see this post describing that financial [...]
[...] Health Populi’s Hot Points: Workers would be well-advised to save their money, maxing out both their 401(K) plans as well as conserving funds for future health care needs. That’s because, once you lose your job in America, unemployment often leads to uninsurance. The cost of paying for health insurance under COBRA coverage can exceed the average monthly unemployment check. [...]
[...] Health Populi’s Hot Points: Workers would be well-advised to save their money, maxing out both their 401(K) plans as well as conserving funds for future health care needs. That’s because, once you lose your job in America, unemployment often leads to uninsurance. The cost of paying for health insurance under COBRA coverage can exceed the average monthly unemployment check. [...]