Losing jobs can mean losing insurance coverage

Bill Knight column for 4-16, 17 or 18, 2020 

U.S. health-insurance coverage is sick – even if it’s through an employer.

Insurance provided through employment just isn’t enough in the public-health crisis now before us, and job losses can mean also losing coverage and financial catastrophe.

COVID-19 treatments could cost some $35,000, Time magazine reported, and there are unexpected related expenses. Bennington (Vt.) College professor Andrew Cencini told the New York Times he’s facing an unforeseen $2,000 bill stemming from doctor-ordered testing after he’d shown symptoms of the virus – and he turned out to be negative for the virus.

Up to 30% of working people could lose their jobs, according to the Federal Reserve Bank of St. Louis, far worse than the last recession in 2008-09, when more than 9 million of us lost our health insurance, according to the National Bureau of Economic Research. Already, the number of jobs lost in the three weeks before last Thursday (April 9) exceeds the 15 million that the Great Recession took 18 months to lose between 2007 and 2009.

About half of Americans, some 150 million workers, get health insurance from their employers, according to Kaiser Family Foundation, so losing employment has consequences beyond losing paychecks. Without an income, it’s extremely difficult to pay premiums on a new private policy. Plus, President Trump refused to reopen enrollment in the Affordable Care Act, shutting off at least a lifeline, if not a rescue.

“Americans are about to learn something horrifying: how irrational and irresponsible it is for so many to be dependent on employers for health insurance. Take it from me. I’m a former health-insurance executive who once profited from this system. It’s time for it to stop,” said Wendell Potter, the one-time vice-president for corporate communications at Cigna who’s now president of Business for Medicare for All.

“This system cannot handle our current reality,” he added.

Before the public-health disaster unfolding and accelerating this spring, there already were millions of people considered “underinsured” because of high deductibles and co-pays, causing many sick people to skip needed care or medicine, according to a study last year by the Commonwealth Fund, a nonpartisan nonprofit that researches health policy. The percentage of underinsured grew from 24% in 2014 to 29% in 2018.

Now, 80 million are underinsured or uninsured, says Kaiser Family Foundation.

“More people have health plans that fail to adequately protect them from health-care costs,” said Sara Collins, lead author of Commonwealth’s study, “with the fastest deterioration in cost protection occurring in employer coverage.”

Physician David Blumenthal, Commonwealth’s president, added, “It may be time for policymakers to pay some serious attention to the relatively quick erosion of employer coverage and its impact on workers.”

Meanwhile, the Covered California insurance marketplace analyzed the pandemic’s estimated costs to health insurers and predicted that health-insurance corporations next year will hike premiums between 4% and 40%.

Apart from insurance, the Senate-authored Families First Coronavirus Emergency Response Act provides for paid sick leave – to help encourage symptomatic workers to stay home. However, just 12% of U.S. workers qualify in businesses that remain open, according to a report in the Washington Post. Already, almost one-fourth of the American work force has no paid sick leave, the Bureau of Labor Statistics says.

Besides public employees (many of whom already have paid sick leave through union contracts), the law applies only to employers with more than 50 and fewer than 500 workers, so small businesses aren’t affected, and companies such as Kroger, Shell, Target and Walgreen’s aren’t either, according to the Post, unless labor agreements are in force at some locations.

Finally, places still operating – “essential services,” governments determined – include cashiers, housekeepers, and child-care staff, and 40% of such workers in close contact with the public are uninsured, according to the Occupational Information Network.

There are ailments beyond the virus, and we must seek remedies beyond vaccines.