Unemployment has skyrocketed during the Coronavirus pandemic. In Massachusetts, nearly half a million people — more than 10 percent of the state’s labor force — have filed for unemployment benefits since mid March. However, losing your job is only part of the challenge, and many are also worried about losing health insurance in the midst of a public health crisis.
“We're seeing a lot of activity among our existing members ... as well as new people coming into coverage,” said Audrey Morse Gasteier, chief of Policy and Strategy at the Massachusetts Health Connector, the state’s health insurance marketplace where people can sign up for a plan.
Since the beginning of March, about 14,500 people reported a change in income to the Health Connector and moved to a different plan type, often a cheaper, more subsidized plan. Another 7,800 Health Connector members reported a change in income and are moving to MassHealth, the state’s Medicaid program. Plus, the Health Connector saw 17,500 new enrollments in that time.
About 300,000 people in the state get their insurance through the Health Connector.
Many of the new enrollees are people who’ve lost jobs, but some are people who have been without coverage for months or longer “who are newly realizing how valuable and important having health coverage is as we face the Coronavirus crisis,” Gasteier said.
Gasteier said there are a few things to know about signing up for health insurance amidst this economic and public health crisis.
First, in this pandemic, the state — unlike the federal government — announced a special open enrollment period where anyone can sign up for coverage through May 25th.
Second, newly unemployed individuals “have 60 days from the loss of that job-based coverage to come into coverage through the Health Connector and that’s independent of the special enrollment period that we’re offering right now,” Gasteier said.
For those already buying health insurance through the Health Connector, Gasteier said they should update their profile to include any changes in income. A loss of income might mean they qualify for more subsidized insurance or for MassHealth.
Jose Figueroa, a physician at Brigham and Women’s Hospital and a professor at Harvard’s School of Public Health, said the other option is COBRA, which is designed for people who were laid off and want to keep the insurance they had from their employer for up to a year and a half.
“There is one major issue, and that's the cost of getting COBRA coverage,” he said.
With COBRA, the individual must pay the entirety of their premium. Previously, most of the premium was covered by their employer.
“That usually means that you have to pay about four or five times as much per month to keep that same insurance,” said Figueroa.
In Massachusetts, the average cost is more than $600 a month for an individual and $1,600 per month for a family. And, of course, this cost comes right as the person stops getting their paycheck.
Figueroa said he worries about all the people who don’t get COBRA coverage, who don’t qualify for MassHealth and who opt not to buy insurance on the state exchanges.
“That’s a huge concern,” he said.
And the problem is nationwide. There are almost 28 million uninsured Americans who may delay seeking care until things are particularly dire.
Figueroa said, in the end, somebody has to pay for their care: Either it’s the patients paying out of pocket, the government picking up the tab or hospitals and the health care system footing the bill.
“I think it's going to be a combination of all three,” Figueroa said, “And, of course, we're talking about the economic recession at that point.”
Figueroa said this pandemic is shining a light on all the weaknesses in our health care system. And when we get through this crisis, he’d like to see changes that ensure the system is better prepared and patients are better protected for the next outbreak.