[SnorkelTan]

I quit my job as a dev to care for my father who has dementia. Using COBRA and paying for the identical health insurance I had from my employer is $1,000/mo. I have no dependents. California minimum wage annual income is ~$32k. Almost half the income of someone who works a shit job. I'd say that almost 50% of minimum wage just for the privilege of going to a doctor when I have a problem is rightfully a pretty big deal.

[vineyardmike]

This is the issue with American healthcare - it’s super confusing and people don’t even understand that they have better options. And of course, living with a super pricy COBRA plan while being unemployed is not the normal experience for people, and also not the actual “optimal” way to get healthcare in that situation.

COBRA isn’t meant to be a full healthcare insurance, it’s meant to be a “bridge” care for people in between jobs (that’s why it’s tied to your prior employers plans). You also don’t even need to pay the COBRA premiums unless you actually use it, so you can save that $1K/mo while being implicitly insured (helpful in case you only really want to be insured against catastrophic accidents).

If you were not working because you were caring for a dependent (like a sick adult), or if you’re a minimum wage worker, you wouldn’t use an employer sponsored plan through COBRA, you’d use Medi-Cal (California’s expanded Medicaid) or the ACA marketplace, and could be “free” or ultra low (premiums). Medi-Cal is free, and the ACA plan for a 45yo male in SF making Cali minimum wage (34k/yr) would pay $18/mo.

Healthcare is absolutely a “pretty big deal” and absolutely the system is terrible. But if you actually made 34k/yr, it probably makes sense to spend 1hr googling for the actual programs that exist so you’d discover that you can get it for much cheaper.

[SnorkelTan]

I take a biologic that costs $5,000 a month without a prescription. $1k a month is honestly easier and I can afford it. I enjoy the luxury of being able to afford to not have to navigate the stupid “oh, so you’re poor” patchwork bullshit that exists. My roommate is not such a person.

[nradov]

No, that's not how it works. Poor people who lose coverage from employer-sponsored health plans don't pay COBRA premiums out of pocket. They spend much less to either buy a subsidized health plan on the state exchange or go on Medicaid. The system is a mess but let's not exaggerate the problems.

[SnorkelTan]

I can’t imagine getting Medicaid to cover the biologic that I take that costs $5,000 a month without a prescription to be anything other than a nightmare.