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by avip 2823 days ago
What happens in the US if you leave your employer when in a degraded health state (let's say cancer)?
6 comments

You have a few options. Here they are in descending order of preference

* Hope your employer is compassionate and keeps you on their plan. I have no data on this, but anecdotally it is surprisingly common. Companies can be heartless when dealing with large groups of employees, but it is much harder to rip away Karen from accounting's health insurance as she is going through chemo.

* Hope your spouse (or parents if you are young enough) has insurance and they can add you to their plan.

* Buy in to your current insurance plan through various government programs (COBRA is one program that a lot of other comments are mentioning) . I don't have all the details on how this changed after Obamacare, but there were generally limits on how long you could do this and the costs were much higher than what your plan previously cost you and your employer.

* Buy a new insurance plan on the open market. This would have been obscenely expensive for someone with cancer before Obamacare's preexisting condition protections, but even with those reforms it still is a huge expense.

* Pay for your medical care out of pocket, which in the case of cancer will almost certainly result in you going bankrupt. Depending on where you get your statistics, there is something like 500,000 - 1 million bankruptcies in the US a year that are related to medical expenses.

> 500,000 - 1 million bankruptcies in the US a year

Really? So, assuming there's 125 million households in the US, a person has ~25-50% (derived with simple probabibility math) of becoming bankrupt over medical bills at some point of their life? That sounds like BS.

A bit more than half of bankruptcies are medical. And you're forgetting that someone can declare bankruptcy multiple times in their life. But yes, it's a savage system.
The Affordable Care Act did stop the practice of refusing coverage for preexisting conditions. So you can get insurance. The cost is high getting it on your own, not due to the condition, but because the employer isn't subsidizing it.

See https://www.hhs.gov/healthcare/about-the-aca/pre-existing-co...

For acute emergencies, like a heart attack or car accident, US hospitals are obligated to treat your immediate needs if you enter the lobby.

You just clutch your chest and say, "Help, I think I'm having a heart attack!"

Sadly, cancer doesn't qualify. Either you pony up $50,000 - $200,000 in the hospital lobby, or they call a security guard and escort you out of the building. Then you go home and die.

Pretty good summary of "uncompensated care" here:

https://www.usatoday.com/story/news/politics/2017/07/03/who-...

The 1985 Emergency Medical Treatment & Labor Act requires hospitals to provide emergency services "regardless of ability to pay".

https://www.cms.gov/Regulations-and-Guidance/Legislation/EMT...

You go bankrupt and die.
Under certain circumstances, you can continue under your employer's plan for a certain period of time at more than two times the cost.

Of course, you now how have the problem of paying more than double in premiums alone without an income.

Best approach is probably to be a multimillionaire...