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Wayne Independent - Honesdale, PA
  • Unemployed and uninsured: a double whammy

  • According to the health consumer organization Families USA, 98,500 Pennsylvanians lost their health insurance coverage in 2009 due to unemployment.


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  • According to the health consumer organization Families USA, 98,500 Pennsylvanians lost their health insurance coverage in 2009 due to unemployment.
    “The state’s average unemployment rate in 2008 was 5.4 percent, while the average rate this year was 8.0 percent, thereby resulting in losses of health coverage,” says the organization’s recent press release. “The Families USA report is based on the link between rising unemployment and health insurance coverage losses. Most Americans—61.9 percent of those under the age of 65—get their health coverage through their own job or that of a family member. Job loss, therefore, usually means loss of health coverage because other options, such as COBRA and individual coverage, are usually prohibitively expensive.”
    Unaffordable
    A Waymart woman named Carol, last name withheld for privacy, knows what it’s like not to have insurance. After six years with the same utility company, Carol recently quit her job due to high stress. But no job meant no health insurance.
    Not one to get sick, Carol wasn’t worried. Three months later, she wound up in the emergency room.
    “I was nauseous (with) pain across my belly. I couldn’t do anything ...I was sick as a dog, crying, beside myself,” she says. Turns out, she had kidney stones. She was treated and released.
    Three days later, she’d be back at the ER, now unable to breathe. Carol figures the morphine treatment for the kidney stone pain may have triggered the breathing problem. Feeling better after a breathing treatment, she was given an antibiotic and sent home.
    Nothing could have prepared her for the bill. Her two trips to the ER, which included two CAT scans and an x-ray, had totaled nearly $6,900. “Boy did I feel like I got kicked in the seat of my pants,” she said.
    Having quit her job, Carol wasn’t receiving unemployment. Though she lived frugally and counted her pennies, the big bill was more than she could handle. “I’m trying to do the right thing. I did want to pay,” she said. So she contacted the hospital, explained her situation, and negotiated the bill down to $2,350.
    “The COBRA was going to be $538 a month (for individual coverage). This is actually my fifth month out of work. I’ve actually paid less in negotiating my hospital bill down then a COBRA would have cost me,” she said.
    Double whammy 
    "Historically, we've linked health insurance to employment, so you get this double whammy when we get into a recession. It is tough,” says Berry Friesen, public affairs manager for the PA Health Access Network, a coalition that supports access to affordable healthcare for all Pennsylvanians.   
     "The leading proposals in Congress attempt to strengthen the connection between employment and health coverage. I think that direction is the right one. What will be added if these proposals become law are insurance exchanges where the uninsured can buy coverage at a subsidized rate. The cost to the consumer will be based on his or her income at the time, and the balance will be paid out of public funds. In other words, for the uninsured, the cost of the premium will be scaled to one's income,” he said.
    Page 2 of 2 - "This won't be true for everybody, just the uninsured and self employed. The rest of us will continue to be covered through insurance arranged by our employers,” Friesen said.
    Employers dropping coverage
     "Our health insurance crisis is driven by two causes: people losing their coverage because they've been laid off and employers dropping coverage because they can't afford the cost,” says  Friesen.
    "The number of people who are covered by employer-based coverage is dropping very fast. We had 7.1 million people covered through their employer in 2008 in Pennsylvania. (That figure includes spouses, children and workers). That's down by 250,000 from 2007, the biggest drop we've seen. Projections for this year show an even bigger drop in employer-based coverage in 2009,” he said.
    “Congress is considering reforms to address this problem. First, small employers also will be able to buy coverage at an insurance exchange. The exchange would pool risks, thereby creating access to volume discounts and greatly reducing the impact medical costs from a few employees can have on an employer's premium. This would enable small employers to buy coverage at a fair price and without fear of rate spikes. Second, small employers also will be eligible for subsidies, just like the uninsured, to further bring down the cost of coverage,” he said.
     
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