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Friday, August 26, 2011

Jobless find silver lining in health reform

Erin Kelly

Staff Writer

What would you do if you lost not only your job, but also health insurance for yourself and your family? Would you dip into your children’s college fund to pay for costly premiums? Would you elect to go without coverage so you could put food on the table? Unfortunately, thanks to the recession, far too many Americans have to face difficult decisions like these.

A new report by the Commonwealth Fund shows that almost 60 percent of working Americans get their insurance through their employer. This means that when they lost their jobs during the recession, many also lost their health coverage. An estimated 15 million adults lost their job-based coverage between the years 2008 and 2010. So what happens next?

According to the report, it isn’t easy finding affordable coverage in the private market. A whopping 60 percent of adults under age 65 found it “very difficult or impossible to find a plan they could afford.” And 35 percent had a specific pre-existing condition excluded from their plan, were charged a significantly higher price, or were even flat out denied coverage.

The report does mention that while 25 percent of those who’ve lost coverage from 2008 to 2010 are able to get coverage through their spouse’s job-based plan or another source, more than half of the 15 million became uninsured. And according to a report by Families USA, rising uninsurance has affected every state—those state with higher unemployment rates suffering the greatest percentage of loss of coverage.

If you’ve ever gone without insurance, you know it can be scary. Out-of-pocket costs for doctor visits can be a few hundred dollars and tests can easily cost patients thousands of dollars. With no insurance to help defray the costs, many uninsured Americans go without necessary medical care.

In fact, according to the study,

  • 47% did not fill a prescription due to high costs;
  • 52% skipped a recommended follow-up test or medical treatment; and
  • 50% did not see get the physician or specialist care they needed.

Under the Consolidated Omnibus Reconciliation Act (COBRA), certain employees can keep their job-based group coverage after they lose their job, but they must assume the full cost of the premiums. While COBRA helps some Americans keep their coverage, it can be too expensive for those who have just been laid off.

The Affordable Care Act, however, is designed to alleviate problems like these. Thanks to the new law, more Americans will now qualify for Medicaid, the safety-net program designed to help those who make too little afford insurance in the individual market. Further, sliding-scale subsidies will be given to hardworking, middle-class Americans who need help affording premiums in the private market. Families of four making up to four times the federal poverty level ($88,200 in 2010) could qualify for these tax credits in 2014! And that same year, insurance companies will no longer be able to deny adults with pre-existing conditions coverage.

Before health reform, those who have been laid off typically lost their insurance and had few viable options to keep their health coverage. Now and throughout the implementation of the Affordable Care Act, Americans will have more options to keep the coverage their family depends on.