Many laid-off workers face first deadlines to qualify for health insurance

May 24, 2020 11:10 PM PT

WASHINGTON — Many laid-off workers who lost health insurance in the coronavirus shutdown soon face the first deadlines to qualify for fallback coverage under the Affordable Care Act.

Taxpayer-subsidized health insurance is available for a modest cost — sometimes even free — across the country, but industry officials and independent researchers say few people seem to know how to find it. For those who lost their health insurance as layoffs mounted at the end of March, a 60-day “special enrollment” period for individual coverage under the ACA closes next week in most states.

Altheia Franklin, who lives near Houston, lost her medical plan after being laid off from a job at an upscale retirement community, as a counselor to seniors making the move. Stay-at-home orders and higher virus risks for older people have put such life transitions on hold in the pandemic.

Franklin said she received plenty of government information about coronavirus safety and economic stimulus payments, but “the insurance piece just has not been mentioned.”

She scrambled and finally found an ACA — or “Obamacare” — plan she could still afford on a reduced income. “We are in the middle of a pandemic, and God forbid if I get sick and I don’t have it,” she said of her health insurance.

The nonpartisan Kaiser Family Foundation estimates that nearly 27 million workers and family members had lost job-based health coverage as of the start of this month, a number now likely higher with unemployment claims rising.

In a counter-intuitive finding, Kaiser’s study also estimated that nearly 8 in 10 of the newly uninsured would likely qualify for some sort of coverage under former President Obama’s health law, either a private plan like Franklin found, or Medicaid.

“The ACA is there as a safety net for the first time in an economic downturn,” said Kaiser foundation expert Larry Levitt. But “many people losing their jobs have never had to think of relying on the ACA for coverage, so there is no reason they should be aware of their options.”

There are several options, not easy to sort through. Some have application deadlines; others do not. And the Trump administration, which still plans to ask the Supreme Court later this summer to declare “Obamacare” unconstitutional, is doing little to promote the health law’s coverage. Here’s a quick look:

Subsidized private insurance

Like Altheia Franklin, people who lose workplace insurance generally have 60 days from when their coverage ended to apply for an ACA plan. They can go to the federal HealthCare.gov or their state’s health insurance website. Most states that run their own health insurance marketplaces have provided an extended sign-up period for people who lost coverage in the pandemic. The federal marketplace, serving most of the country, has not.

Medicaid for adults

Nearly three-fourths of the states have expanded Medicaid to low-income adults under the Obama health law. In those states, low-income adults can qualify for free or very low cost coverage. There is no sign-up deadline. The Kaiser foundation estimates that nearly 13 million people who lost job-based insurance are eligible for Medicaid. But that option is not available in most Southern states, as well as some in the Midwest and Plains, because they have not expanded Medicaid.

Children’s health insurance

Laid-off workers should be able to get their children covered even if the adults in the family cannot help. The federal-state Children’s Health Insurance Program and Medicaid cover kids in families with incomes well above the poverty level. “Medicaid is open year round if you are a parent with kids who need coverage,” said Joan Alker, director of the Center for Children and Families at Georgetown University. Children’s coverage predates the ACA.

COBRA

People can continue their employer coverage under a federal law known as COBRA, but they have to pay 102% of the premium — too much for most who are out of work. If there’s another coronavirus bill from Congress, it might include subsidies for COBRA coverage.

Government statistics on people losing — and finding — health insurance coverage in the coronavirus contraction won’t be available for months.

The head of a California company that helps people find ACA coverage says most of the new sign-ups they’re seeing are people who qualify for Medicaid, and there’s been only a modest uptick for subsidized private plans.

“We are all wondering where the heck is everybody,” said George Kalogeropoulos, CEO of Health Sherpa.

“People first are trying to apply for unemployment, and many of them getting stuck there,” he added. “Healthcare is the secondary thing, and if they get stuck in unemployment, people may never do the healthcare thing.”

Alker, the Georgetown University expert, said insurance protection has been neglected in the pandemic.

“Having health insurance has never been more important,” she said. “We need a national commitment to make these newly uninsured people aware of their options.”