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NPR Health

What Happens To Health Coverage After The Job Loss

MARY LOUISE KELLY, HOST:

OK, to a deadline that is now approaching for the millions of people who lost their health coverage as coronavirus shutdowns first began in March. Now, at the end of May, the window is closing to enroll in a new insurance plan. And there is not a lot of guidance out there to help people navigate finding one. Here to tell us more is NPR's Selena Simmons-Duffin. She covers health policy. Hi, Selena.

SELENA SIMMONS-DUFFIN, BYLINE: Hi, Mary Louise.

KELLY: So I know you love talking policy. But can I start just with the human aspect to this?

SIMMONS-DUFFIN: Of course.

KELLY: 'Cause I know you've been talking to people, some of these folks who've lost their coverage. What are they telling you? What's it been like?

SIMMONS-DUFFIN: Oh, it's just so stressful. With the pandemic, the chance that you could get really sick is higher, and people might be looking for new jobs, worried about rent or food. Adding the need to find health coverage on a deadline is just a lot. I talked to Liz McLemore. She was laid off from a digital marketing job, and she lives in Inglewood, Calif. So she lost her job in March and, with it, the plan that she had through her job. She always got insurance through her job. She never had to think about it. And suddenly, she had to figure out finding a plan.

LIZ MCLEMORE: The whole system is so convoluted and really expensive. At a time when you don't have money coming in, you have this additional huge expense. It's just - it's overwhelming.

SIMMONS-DUFFIN: So she went through a lot to enroll in a new plan on the California Affordable Care Act insurance exchange. She had to call her county at one point and talk to the insurance company. Calculating her income was really tricky. And she says it took her, like, two months, but she was really determined.

MCLEMORE: Because we were in the middle of a pandemic. So I wanted to make sure if I needed to go to the hospital to get any kind of care that there wouldn't be an issue with that.

KELLY: So did she get coverage in the end? What happened?

SIMMONS-DUFFIN: Yes, she did. She got a Bronze Plan on the California exchange. She went from paying $60 a month with her job-based plan to $320 a month. But she says the extra $600 a week that's coming with her unemployment benefit is helping with that expense for now. And she says she just really feels for people who don't have the time or patience to be able to fight through to get covered.

KELLY: Which is millions of people right now who are wrestling with this. What are their options if they have lost coverage?

SIMMONS-DUFFIN: Yeah, that's true. The Kaiser Family Foundation estimates as many as 27 million people lost health coverage by early May. For those people, there are a few options. There is Medicaid, which is based on monthly income. And you can enroll at any time, but the cutoff and eligibility varies by state. So it's an option that's essentially free for beneficiaries if you can get it where you live. There's COBRA, where you essentially continue your job-based coverage, but you have to pay the full premium. And then there's the Affordable Care Act exchanges. And that's what Liz McLemore was able to use. This is the first recession where this option has been around. And if you want to use it, you do have 60 days from the coverage loss to enroll in a new plan. So that is the deadline people are coming up against now.

KELLY: OK. But an additional challenge - we know the federal government is arguing in the Supreme Court that the Affordable Care Act should be struck down. And most states do use the federal health insurance exchange, healthcare.gov. How is all that going to play out?

SIMMONS-DUFFIN: So one way that tension is playing out is that the federal government has declined to use some of the tools at its disposal to make this process easier for people to know about and navigate. The Trump administration cut the advertising budget for the health insurance exchanges by 90% a few years ago. So a lot of people just don't know that this option is there, let alone that there's a 60-day deadline coming up.

The Trump administration also opted not to create a federal special enrollment period right now. And that would've allowed anyone to enroll. You wouldn't have to document a job loss or a coverage loss. You could just go in and choose a plan. So today, I asked the Centers for Medicare & Medicaid Services, the agency that runs healthcare.gov, if any action was being taken to reconsider the special enrollment period or extend the 60-day deadline. But I have not gotten those answers back yet.

KELLY: All right. Please come tell us when you do. That is NPR health policy reporter Selena Simmons-Duffin. Thank you.

SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.