By Dave Anderson:
I've been a combination of out of work and/or underemployed for several months now.
When I was employed full time, my employer provided mediocre quasi-catastrophic medical coverage that became the basis for my COBRA plan. My previous employer must have either have had either a horrendous HR negoatiator (unlikely) or a risk pool full of 55 year old diabetic cancer survivors as the premiums for COBRA coverage for my family were amazingly high for what was a high deductible, low usefullness insurance plan. When I was laid-off, my family benefitted from the ARRA subsidy for COBRA but after January 1st, the high deductible for the plan reset and basically made it "hit by the bus and still be in deep shit" insurance for all of us.
We recently moved our daughter to Pennsylvania S-CHIP because it is a better insurance plan and significantly cheaper. Full-price Pennslyvania S-CHIP in my home county ranges from $125 to $230 per month. Full-price S-CHIP must cover the cost of medical services, administration and overhead.
We chose one of the lower price plans because it includes our pediatrician, has a great network of providers nearby and covers the vast majority of probable services that Elise will need as a toddler.
We receive an $80 per month subsidy for Elise. Our out of pocket payment post-subsidy is significantly less than our monthly post-ARRA subsidy premium for COBRA. SCHIP is better insurance with better preventive care services and better catastrophic coverage for my daughter in case she falls down at the playground, breaks her crown and couldn't get up in the morning than the private sector ARRA subsidized at the rate of $200+ per month COBRA insurance that guaranteed a financial black-hole if anything serious happened to her.
The publicly funded, privately administered SCHIP is giving my family much greater piece of mind at a much lower public expenditure while also freeing up some extra cashflow for us to spend on neccessities but if my daughter was over the age of 2, we would not have been able to switch her to a cheaper, and better public program without having her be uninsured for six months.
Ahh, the cult of the private market, shovel money and insecurity at it for the government can't do anything right....
If there is another COBRA subsidy extension, I hope a Democratic congress-critter offers an amendment to give a "floating" subsidy equal to X% of COBRA premium that can be used for either COBRA or CHIP or other federal health insurance programs and the uninsured duration eligibility requirement is waived. That amendment would save the Feds some money, save some families some money and keep on chipping away at the myth that no government program can outcompete on multiple metrics the private market.
Despite Republican attempts to kill SCHIP it survived. Here in Georgia it's called "Peachcare" and one of my grandchildren was covered for a while when his parents, starting a new business, fell below the income means test. Their new business soon grew enough to qualify for a group insurance policy.
ReplyDeleteA little-discussed result of universal health care is the eventual end of job lock. Employer group insurance is a golden handcuff for many who might otherwise either leave for another job or start a new business.
The acronym COBRA is symbolic. Those facing the unsubsidized amount of insurance premiums upon leaving a job are like victims of a cobra bite, losing income at exactly the same time that a major expense frequently nearly doubles. (And all that yelling about "reconciliation" was an ignorant expression since the acronym is for Consolidated Omnibus Budger RECONCILIATION Act.)