Nearly three-quarters (72 percent) of people who lost their health insurance when they lost their jobs over the last two years said that they skipped needed healthcare or did not fill prescriptions because of cost, according to a new Commonwealth Fund report. The same proportion is also struggling with medical bills or medical debt, compared to about half (49 percent) who lost jobs but not their health insurance.
Six in 10 working Americans rely on health insurance obtained through their employer, and when an estimated 15 million working-age adults lost their jobs and their employer-based insurance between 2008 and 2010, nine million became uninsured. Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), people employed by companies with 20 or more workers and have health insurance sponsored by that company can keep their health insurance for up to 18 months if they lose their job. However, because unemployed workers must pay the full premium, few people elect to continue their coverage through COBRA.
The report finds that once the major coverage provisions of the Affordable Care Act are implemented in 2014, job loss will not automatically mean going without health insurance, because the newly unemployed will have greatly expanded health insurance options, including subsidies to purchase insurance through exchanges, and expanded access to Medicaid coverage. "Currently, for a majority of Americans, losing a job also means losing health insurance," said Commonwealth Fund Vice President and report co-author Sara Collins.
"To make matters worse, once you are unemployed and uninsured, it's nearly impossible to afford COBRA or buy an individual policy. However, when it is fully implemented in 2014, the Affordable Care Act will usher in a new era for the unemployed, who will have a variety of options."
The report, based on findings from The 2010 Commonwealth Fund Biennial Health Insurance Survey, notes that last year 57 percent of those who said they had lost their job with health benefits in the past two years became uninsured because they had limited options for acquiring affordable health insurance. Additionally, researchers have found that COBRA is less likely to be an option, as only 25 percent of workers with incomes less than 133 percent of poverty (just under $30,000 for a family of four) would have been eligible for COBRA if they had lost their jobs, compared with 73 percent with household incomes at 400 percent of poverty or more (just over $88,000 for a family of four).
The individual insurance market is also not a viable option for those who have lost a job and health insurance. The report finds that 60 percent of people who shopped for individual insurance policies over the last three years were unable to find a plan they could afford, and 35 percent were turned down by an insurer, charged more because of their health status, or had a specific health problem excluded from their coverage.