People with health issues should still be able to purchase their existing insurance through COBRA, and, once that expires, through the public exchanges that are guaranteed to cover their existing condition. Thanks ACA.
When I left Microsoft I believe the cost I was quoted for COBRA was thousands a month - not quite as much as my salary when I was working there but enough that it would have rapidly depleted my savings if I didn't find another job immediately.
When you enroll in COBRA, you are responsible for paying both the employer's contribution and your own contribution. This can amount to thousands of dollars per month. It may be more cost-effective to consider state insurance options or those available on healthcare.gov. I took COBRA in the past and I know about this.
Entirely serious question: is COBRA actually of any use to anyone? From where I sit it's always been pretty aspirational since it requires you to also pay the employer side of the insurance which is colossally more expensive than the employee side, and you are expected to do this while being out of work?
It's useful for 60 days, since for 60 days (or maybe it's 90 or 30, I forget -- look it up yourself if you need it, don't listen to me) you can elect it retroactively. So you can go without insurance, and as long as you haven't hit the 60 days, you can retroactively pay for it if a devastating emergency happens. Actually dealing with this would be a huge logistical hassle, and god help you if you're hospitalized, unconscious, and can't file the paperwork or get someone else to, but at least you probably wouldn't go bankrupt.
Hopefully that buys you some more time to find a new job or line up an ACA plan if you're in a state with decent ACA plans, because actually paying for COBRA out of pocket for months at a time is indeed very expensive.
(It also would be totally worth it if you had existing expensive health care needs in your family)
Just to be clear. Employees ARE paying that full amount while employed. It is part of their benefits. They don't feel the cost, but it is there all the same.
No, that’s not it. The cost is sky high because its the price that your employer, plus you normally pay. At tech companies in particular where the employer usually picks up 90-100% of the cost, it makes COBRA look crazy expensive when you suddenly have to pay 100% instead of 10%.
I believe it; but is interesting in the context that I have purchased ACA plans on the open market comparable to my company insurance, and they were far far below the cobra price. For reference a basically identical ACA healthcare.gov plan I bought for ~1k when COBRA charged something around $3k.
There’s a hack for COBRA if you’re immediately switching jobs: Sign up for COBRA but don’t make the payments. If something really bad happens before coverage at your new employer kicks in, make the payments and the claims.
You can opt out of it (or not opt in) up until, I believe (and correct me if I'm wrong) for up to a year after leaving the job meaning that you can deny coverage UNLESS something major comes up then you pay from that point on. So it's useful for that event, some emergency coming up.
I've never paid for it, the one time I had it come up it was something like $800/mo for me as a single 20s laid off person. Not top priority.
> once that expires, through the public exchanges that are guaranteed to cover their existing condition. Thanks ACA.
The ACA just states that insurers can't refuse a customer who wants to purchase a plan just because they have a preexisting condition. It doesn't actually require that the plan cover treatment for said condition.
In many states - including wealthier deep blue states - the marketplace plan options are actually quite terrible.
> Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition.
No, you are misreading it. They cannot limit benefits due to your condition, but that doesn't mean that they have to cover treatment for your condition.
If you have a disease or syndrome, the treatments for that condition (whether pharmaceutical, outpatient, or inpatient) may simply not be on the list of benefits provided by the insurance plans offered.
It's legally distinct from, but analogous to, a nodiscrimination clause. They can't refuse to cover your mammogram (which they cover for everyone else) just because your initial diagnosis for Vamipiric Brain Syndrome occurred before your plan went into effect. But they can choose to say they they don't cover Nosferatudone for anyone (when Nosferatudone happens to be the only effective treatment for Vamipiric Brain Syndrome).
(There are, separately, certain treatments that all insurance plans must cover by law, although that's separate from the ACA, and it's a very limited set).
The ACA has "minimum value" requirements and defines what constitute "essential health benefits" that plans must include to satisfy the ACA's coverage requirements and be eligible for sale on healthcare.gov or state-level marketplaces: https://www.healthinsurance.org/obamacare/essential-health-b...
> The ACA has "minimum value" requirements and defines what constitute "essential health benefits" that plans must include to satisfy the ACA's coverage requirements and be eligible for sale on healthcare.gov or state-level marketplaces
Yes, I'm well aware of that, and those requirements are incredibly bare-bones. Nearly any insurance provided by employers far exceeds those requirements, whereas the same cannot be said for insurance provided on the marketplace.
This post is about people who are losing employer-provided insurance, and there's almost no universe in which the non-COBRA options available to most of those people aren't markedly worse than what they're losing, even if we ignore the increased cost of self-purchased insurance.
Yes, you're always able to buy a bad health insurance plan. But you're also able to buy a good health insurance plan, and your pre-existing condition won't impact the price of the good insurance plan.
> Yes, you're always able to buy a bad health insurance plan. But you're also able to buy a good health insurance plan,
If one exists, and as I stated in the original post, in many states, even the best plans available on the marketplace are quite terrible. And that's a problem that's actually gotten worse in recent years, not better, as plans have left the exchange (and providers have dropped marketplace plans from their networks).
> and your pre-existing condition won't impact the price of the good insurance plan.
Your "pre-existing condition" won't impact the price of the insurance plan relative to others who are purchasing that same plan, but you quite likely will be in a situation where the "good" (eg, gold) plans are the only ones which will provide the coverage that you need, and those are the most expensive ones. This satisfies the letter of the law, but in practice it still means that often people with chronic health condition either are are forced to pay more for coverage or are literally unable to get coverage for their conditions at all (because none of the marketplace plans will cover it).
The protections provided by the ACA are much more narrow than you're portraying them as, which is understandable because it's a common misconception about how the ACA operates, but it's unfortunately a very important distinction.
Do you have any evidence that the plans aren't sufficient? Others in the thread have mentioned they have gotten nearly identical plans to their old employer plans. People I know who buy their own health insurance have totally adequate coverage, and this is in a "blue northeast state" that, according to you, has inadequate options.
> Does private employer insurance not have the same limitations?
Yes, but insurance sold to private employers is a completely different market, and it is almost universally better than the insurance plans available on the exchanges.
Doesn't this create a huge incentive for people to buy rolling "temporary" insurance plans which can consider pre-existing conditions, and then switch to subsidizing off the healthy once they actually get a condition and buy the regular ACA plans?
Yes, and that's one reason why costs have ballooned so much, the need to subsidize people who didn't pay while they didn't have a condition and now do. The temporary plans aren't even necessary, if you can wait until the next regular enrollment period.
The ACA originally tried to hide that vulnerability by making insurance mandatory, then it appeared when that forcible mandate was repealed.
Edit to reply to the reply: Right, it's not insurance. Insurance is pooling risk. If you wait until the risk event has already happened, it's not insurance, it's just paying your own costs with extra steps.
... so we have the worst of both worlds. Insurers are forced to take pre-existing conditions, but you can wait until you have a condition before buying it.
I don't think that's even "insurance" at that point....
America may quite possible have the absolute dumbest system humanly possible.
The best part? The US spends more per captia than any other OECD nation on socialized medicine. The United Kingdom's NHS costs around half, per capita and delivers universal coverage.
"Temporary" plans are 1-12 months so you can buy ones that last until the next open enrollment, and if you're healthy you buy another (12 month) temporary plan. If you develop a condition you buy the regular plan.