JustCare

Tag: COBRA

  • Coronavirus: How to help workers who become uninsured?

    Coronavirus: How to help workers who become uninsured?

    Back in April 2020, early in the pandemic, the US suffered from tremendous unemployment. With that, came millions of uninsured. Paul Fronstin and Stephen Woodbury report for The Commonwealth Fund that even though millions of Americans lost their jobs since March 2020, fewer than anticipated lost their health insurance. Whatever the number of uninsured, the Biden administration should ensure coverage for the uninsured and offer workers the choice of health coverage not tied to their work.

    President Biden proposes that the government pay the health insurance premiums–COBRA–for people who have lost their health insurance along with their jobs during this pandemic. That will definitely help the insurers. But, giving people back the high-deductible, high-copay health insurance they had when they were employed is a far cry from helping them when they have little or no income and limited savings.

    Recent estimates suggest that about 7.7 million people who lost their jobs during the pandemic also lost their employer coverage. Including their family members who lost coverage, closer to 14.6 million people lost employer insurance. Both for their individual health and the public health, they should be able to get care without worry about the cost.

    Paying people’s COBRA premiums is out of line with Biden’s desire to provide free COVID-19 testing and treatment for everyone. To provide this coverage, there’s a far better proposal on the table, the Health Care Emergency Guarantee Act. sponsored by Congresswoman Pramila Jayapal, Senator Bernie Sanders and others. It would have the Department of Health and Human Services cover the full cost of care for everyone who lacks health insurance, along with the copays, deductibles and other out-of-pocket costs for people with public or private insurance. That policy solution would ensure that everyone got free COVID care.

    The cost of the Health Care Emergency Guarantee Act would likely be far less than paying for people’s health insurance through COBRA. Estimates are that half of people who were laid off were able to keep their health insurance coverage. More than four in ten businesses that had to let go of workers continued to pay some of their workers’ premiums. Even with COBRA, how many of workers skipped care because the out-of-pocket costs were high?

    Many more workers are likely to lose their health insurance in the coming months. It’s hard to imagine that employers will continue to pay premiums for workers they had to let go. And, it’s likely that in this next wave of the pandemic, fewer employers will pay premiums for workers who they are forced to lay off.

    The best solution for ensuring everyone gets free COVID care and access to all needed care is to improve and expand Medicare to everyone. Short of that, President Biden should support, and Congress should pass, the Health Care Emergency Guarantee Act.

    Here’s more from Just Care:

  • Coronavirus: Sanders’ legislation would pay for everyone’s care during this pandemic through Medicare

    Coronavirus: Sanders’ legislation would pay for everyone’s care during this pandemic through Medicare

    Last Friday, Senator Bernie Sanders (I-Vt.) introduced the Health Care Emergency Guarantee Act which guarantees everyone in the US the ability to get health care without having to pay deductibles, coinsurance or other out-of-pocket costs during the coronavirus pandemic. Six other senators cosponsored the legislation: Senators Kirsten Gillibrand (D-N.Y.), Edward Markey (D-Mass.), Elizabeth Warren (D-Mass.), Cory Booker (D-N.J.), Jeff Merkley (D-Ore.), and Kamala Harris (D-Calif.)

    The goal of the legislation is to ensure no one skips or delays care during this pandemic because of the cost. Americans should be able to get care without worry about whether they can afford it. The legislation covers all costs for people who are uninsured and all out-of-pocket costs for everyone else. And, it would stay in place until everyone was able to get a COVID-19 vaccine.

    The legislation, which is like the Medicare Crisis program sponsored by Representative Pramila Jayapal, is cost-effective and comprehensive. It relies on Medicare to cover people’s care, including prescription drugs, with federal dollars. In Sanders’ words, “When so many people in this country are struggling economically and terrified at the thought of becoming sick, the federal government has a responsibility to take the burden of health care costs off the backs of the American people. The legislation we are introducing today does just that.”

    The public is solidly behind Senator Sanders’ proposal. A Data for Progress poll finds that nearly three in four voters (73 percent) favor having the federal government pay for people’s out-of-pocket health care costs during the pandemic. Notably, a majority of Republicans (58 percent) favor the legislation.

    Far fewer voters support a proposal passed in the House of Representatives that pays the health insurance premium of people who have lost their employer coverage, through COBRA. Not only is Sanders’ proposed legislation less costly, it is also more comprehensive. If Congress pays for people’s COBRA coverage, people are still left with deductibles and coinsurance, along with restricted networks and other bureaucratic hassles. Deductibles in employer health plans average $1,800 a year. Moreover, people who did not have employer coverage who lost their jobs are left without any coverage.

    In fact when voters understand the difference between the two proposals, 61 percent favor Sanders’ bill versus 14 percent who favor  the COBRA bill. The COBRA bill benefits health insurers most; they would reap tens of billions of dollars in revenue if the Senate passes it. It only benefits the uninsured who had employer coverage if they can afford the out-of-pocket costs of their care

    The Sanders bill also prevents hospitals and other health care providers and debt collectors from collecting medical debts, forbids private insurance companies from raising out-of-pocket costs and mandates data collection and reporting regarding COVID-19 health disparities.

    Everyone in the country needs to be able to get treatment for the novel coronavirus before it is safe to reopen the economy. Moreover, the pandemic reveals how critical it is to everyone that anyone who is sick can get the care they need as quickly as possible. That is how to contain the virus.

    More than 30 national organizations and unions support the Health Care Emergency Guarantee Act. You can read the bill here.

    Here’s more from Just Care:

  • Coronavirus: What would it cost the federal government to pay for health care through Medicare?

    Coronavirus: What would it cost the federal government to pay for health care through Medicare?

    Economists at the University of Massachusetts, PERI, have just released a report analyzing the cost of the Medicare Crisis program, a program proposed by Representatives Pramila Jayapal and Joe Kennedy to help 95 million people afford needed health care during the coronavirus pandemic. The researchers find that the cost to the federal government of the Medicare Crisis program is far less than the cost of a proposal by Representative Bobby Scott, which would subsidize COBRA coverage for people who have lost their jobs and their employer coverage.

    Notably, the Medicare Crisis program covers many more people and provides far more generous benefits than the Worker Health Care Protection Act, the bill which would subsidize the cost of COBRA coverage for people who have lost their employer coverage. Specifically:

    • The Medicare Crisis program covers all recently unemployed workers–around 19.2 million people–and their families, regardless of whether they had health insurance through their jobs. The COBRA bill only covers recently unemployed workers who have lost employer coverage–around 12.9 million people–and their families.
    • The Medicare Crisis program covers all health care costs, including deductibles and copays, for all COVID-related care for unemployed workers and their families. The COBRA bill only covers health insurance premiums and does not cover deductibles and copays for any care.
    • The Medicare Crisis program covers all out-of-pocket COVID-19 costs for people with traditional Medicare and people in Medicare Advantage. The federal government picks up the cost for people in traditional Medicare, and Medicare Advantage plans pick up the cost for their members. The Medicare Crisis program also covers Part A and Part B premiums for people in traditional Medicare.
    • The Medicare Crisis program caps out-of-pocket costs for non-COVID care for unemployed workers and people in traditional Medicare at five percent of their monthly income. The COBRA bill does not cover these costs at all.

    The cost to the federal government of the Medicare Crisis program to cover 38.7 million people is $22.7 billion less than the full cost of care for the same number of people under the COBRA bill, $47.5 billion versus $69.8 billion for three months of care. The Medicare Crisis program is far less costly because the federal government would be paying directly for care; it would not be paying private insurance premiums to health insurance companies to cover possible care people received; it also would not be paying the high administrative costs and profits that come with relying on private health insurers. And, it would be paying lower rates; Medicare provider rates are about two-thirds of private insurance rates.

    Here’s more from Just Care:

  • Coronavirus: Health insurance industry still profiting

    Coronavirus: Health insurance industry still profiting

    Unlike almost every other sector of the economy, the health insurance industry appears to be profiting from the coronavirus pandemic. While some people need costly COVID-19 care, elective surgeries have all but disappeared and people are going to the doctor and ER less. The cost of elective and emergency non-COVID care appears to be a lot greater than the cost of treating COVID-19 patients.

    No question that fewer people have health insurance since the coronavirus outbreak. Thirty million people have lost their jobs, and millions have lost their employer coverage. But, so far, that has not affected health insurer profitability.

    Moody’s investor services reported at the end of April that most insurers would remain solidly profitable this year under the most likely scenarios for infection rates and patient health care needs. It noted that most insurers have high levels of excess capital. It also stated that national insurers would make out best.

    UnitedHealth Group showed strong profits in the first quarter of this year. It makes a lot of its money off of Medicare Advantage plans, private health plans that provide Medicare benefits. And, it has been gaining business in that market.

    Notwithstanding their financial situations, insurers are threatening to raise premiums significantly next year if they don’t get stimulus money. They are arguing that they could spend as much as $250 billion on COVID-19 care this year. They want the federal government to subsidize people’s health insurance today.

    Many Democrats in Congress support legislation that would cover the cost of people’s former job insurance, paying for COBRA. But, COBRA does not guarantee people access to care, it simply extends people’s coverage. Most health care coverage comes with high deductibles and copays. Moreover, the proposed legislation only helps people who have just lost their health insurance. And, it is not cost-effective.

    Senator Bernie Sanders and Congresswoman Pramila Jayapal are proposing legislation that would have Medicare cover people’s health care, which is cost-effective and ensures people access to care. It has the added advantage of enabling the government to collect data on who’s receiving care and where resources need to be allocated.

    Whatever happens in Congress, many states limit the amount that insurers can raise premiums from one year to the next. And, generally, premiums for next year need to reflect expected costs, not losses in 2020. Still, one California analysis suggested that health insurance premiums could rise as much as 40 percent in 2021.

    We don’t yet know how things will work out for corporate health insurers. Right now, many states are requiring insurers to cover people’s COVID-19 related copays as well as to waive copays for telehealth. And, in some states, such as New York, governors have told insurers that they cannot cancel some health plans because of nonpayment of premiums.

    Because of the pandemic, we do know how unreliable and costly employer coverage can be, even when people most need it. Isn’t it time to move to guaranteed health care for all, health insurance people can count on, regardless of their employment status, where they live or their age, health and income?

    Here’s more from Just Care:
  • Coronavirus: How best to guarantee everyone access to care

    Coronavirus: How best to guarantee everyone access to care

    In the face of the coronavirus pandemic, members of Congress are proposing all sorts of ways to help people get health care. One Democratic proposal would be a handout to the health insurance industry; it would cover insurance premiums for ex-workers but require them to pay high deductibles and coinsurance. Senator Bernie Sanders and Congresswoman Pramila Jayapal have a cost-effective proposal that would guarantee everyone 100 percent coverage and easy access to health care.

    The Sanders-Jayapal bill, the Health Care Emergency Guarantee Act, would have the federal government pay through Medicare all costs for COVID-19 care that are not covered through their insurance. And, for anyone without insurance, the federal government would pay for the full cost of their health care. No one would have to pay the deductible or coinsurance in order to get needed care. No one would fall into medical debt if they sought care. And, no one would go without health care because they could not afford it.

    From the perspective of the federal government, the Sanders-Jayapal solution would be cost-effective. The federal government would only pay for services people received. It would not pay the cost of people’s insurance, which would require it to pay even for people not getting care. Moreover, it would pay doctors and hospitals Medicare rates which are lower than private insurance rates.

    The Sanders-Jayapal bill has the added advantage of creating a single real-time electronic billing record for all Covid-19 care. The data would help to track the virus as it moves around the country and provide guidance as to where resources need to be deployed.

    Here’s more from Just Care:

  • Should you get COBRA benefits when you leave your job?

    Should you get COBRA benefits when you leave your job?

    If you are leaving your job, along with your health insurance, you can get insurance through COBRA. But, should you get COBRA? Your state health insurance exchange is now another way to get health insurance if you don’t get it through work. And, it will likely be a far less costly option. But, it may not offer as good benefits.

    What does COBRA do? COBRA allows workers and their spouses and dependents to keep their health insurance coverage from their jobs for 18 to 36 months, so long as the workers pay the full premium.  (Often employers charge an additional 3 percent for administrative costs.) COBRA offers a great protection for people leaving their jobs who don’t want to give up good insurance.  The biggest problem with it for most people, however, is that the full cost of health insurance can be unaffordable.

    COBRA protection is usually available to people who work in companies with 20 or more employees, generally including people who work for state and local governments, but excluding people who work for the federal government. People with costly health care needs benefit most greatly from COBRA since it tends not to be possible to buy individual coverage that is as generous as what insurers offer in the marketplace.  And, when that good coverage is available it tends to be even more costly than the cost through COBRA.

    Even if you have COBRA, you should sign up for Medicare once you become eligible for it.  Medicare becomes your primary insurance.  If you have costly health care needs, COBRA can become your secondary insurer; it may cover services that Medicare does not cover.  (Note: If you do not sign up for Medicare when you become eligible, you will likely end up without any coverage since your COBRA coverage will no longer be primary.)

    For more information, visit Medicare Interactive.