Unemployment and Health Care

Unemployment and Health Care
According to Doty, M., Collins, S., Robertson, R., and Garber, T. (2011), the United States economy is at its worst since the Great Depression of the 1930’s. 13.9 million citizens are estimated to be out of work. Sixty percent of Americans get their health insurance through their employer; job loss most often equals health care benefit loss.
Nearly three quarters of the adults who were laid of from their jobs and are uninsured delay getting health care or filling prescriptions because it is too expensive. The consequences are devastating in terms of individual and family health. Financially the devastation comes from huge medical debt, incurred during an already stressful time.
There are few affordable insurance options for private health care plans. Public health insurance programs such as Medicaid and CHIP (Children’s Health Insurance Program) are available to only pregnant women, children, and parents with very low incomes. Childless adults are covered by less than half of the states. Adults under sixty-five years old could not find an individual plan that they could afford and thirty five percent were turned down because of a pre-existing health problem. Doty, M. (2011), states that individuals who purchase COBRA coverage may pay up to six times more for their coverage than when they were an employee. This is impossible for most unemployed people to afford and as a result most do not buy coverage.
According to Lyons, B., Paradise, J., Perry, M., and Rudowitz, R. (2008), the impact of the economy has caused some families to experience drastic changes in their lives. They have lost their jobs, income and health coverage. They are juggling bills, paying some and skipping others. They are looking for work but are unable to find employment that pays as well or provides comparable health benefits as the one that they lost. Their houses are in foreclosure, some have been forced to move to smaller less expensive places, some move in with family, and some are forced to live in homeless shelters. All of these people are stressed, anxious and having difficulty adjusting to the sudden changes in their lives. An unemployed person from Cincinnati states, “We couldn’t afford the heating oil to heat our house any more. We had to move. It makes me want to cry.” Another states, “I had to move. I am actually in the shelter…me and my kids are. I used to make $80,000 a year.”
Hospitalizations have increased due to the stress of being unemployed, states Lyons, B. (2008). The heads of households are feeling the strain as multiple family members move back home. A woman from Baltimore states,” I can’t take care of everyone. I need someone to take care of me. I just want to get out.” Unemployed men often feel like failures because they cannot protect their families. Marriages are strained and parents try to keep the stress away from their children. “ When my children aren’t covered it causes more stress. I watch them all of the time, saying, don’t do that you might break a bone.” reports a parent from Charlotte N. C.
Delaying care can become a matter of life and death for some uninsured with serious medical problems. The coverage provided by their jobs was the link to medical care needed for survival. After losing their jobs their health and possibly their lives are at risk. According to a patient from Las Vegas, “I was told to see a cardiologist after my heart attack, but I can’t afford it. I know I am sick and I need help.” The unemployed have lost their prescription plans and cannot afford the medications needed to keep them healthy, which in turn increases the patients stress causing exacerbations of the conditions that they need the medicine for in the first place. Then they end up in the hospital facing more stress, due to the anticipation of the hospital bill, Lyons, B.(2008).
Unemployment impacts state and government revenues. According to Garrett, A. and Holahan, J. (2009) the cost for more uninsured people puts additional strain on already tight state budgets because states often finance uncompensated care at local hospitals and clinics. Increased unemployment leads to more people enrolling in Medicaid and CHIP. Fewer workers in the job force decrease the amount of taxes received by the state. The state governments are being forced to make budget cuts and Medicaid is being targeted.
Unemployed people have the option of buying COBRA coverage, but it is expensive because the purchaser must pay for the employee and employers contributions to coverage. Parcham, C. and McAndrew, C. (2009), state that when people are laid off from their jobs and want to continue their health care coverage with COBRA, they must pay the entire cost of coverage with an additional two percent administrative fee. This amounts to 388 dollars a month for individuals and approximately 1,069 dollars a month for families. This is unrealistic when housing, food and utilities need to be paid for with the unemployment check.
Unemployment compensation is roughly 55% of a person’s income. It is based on a percentage of the individual’s earnings over a 52-week period, up to a maximum set by the state. Even when workers have earned enough for the maximum benefit, they usually cannot afford the COBRA payment. For example, according to Parcham, C. (2009), in the state of Nebraska the maximum unemployment benefit for a family is 1,281 per month and the cost of COBRA insurance is 1,012 a month. In other words this family will most likely be without health insurance. As the recession continues, more and more unemployed workers and their families are losing health care benefits. Parcham, C. (2009), states that COBRA continuation coverage could be a health lifeline, but the cost is too high.
Medicaid may not be available for low income unemployed people. Most workers are not eligible unless they have dependent children. Most states disqualify childless adults, no matter how low their income is. The current recession has caused budget deficits in state funds. Medicaid funds are being cut instead of increased to help the newly unemployed.
Parcham, C. (2009) states, “To make COBRA coverage truly affordable, a meaningful subsidy should be provided to recently unemployed workers. For those who do not have the COBRA option, Congress should provide a temporary Medicaid benefit to recently unemployed, low-wage workers.
In conclusion the increase in unemployment causes serious budget issues for state governments and those who are unemployed suffer more than financial hardships. The unemployed worker is under a great amount of strain causing deterioration of individual and family health. When families and individuals are in the greatest need for health care it is most often unavailable to them. As unemployment increases so does the number of new Medicaid and CHIP enrollees. Those who do not qualify for one of these programs and cannot afford COBRA become uninsured and hospitals look to the government to offset the costs of the uninsured inability to pay. Unfortunately, state revenues have decreased due to unemployment just as the need for more money to fund state run programs has increased. A possible answer to this dilemma would be to make COBRA coverage affordable and to provide temporary Medicaid to low income unemployed workers. Individuals and families should have some peace of mind knowing that health care will be available in tough times.

References
Doty, M., Collins, S., Robertson, R., and Garber, T. (2011). When unemployment means uninsured: the toll of job loss on health coverage, and how the affordable care act will help. The Commonwealth Fund. Retrieved from http// www.cwf.org/ 1540/ pdf
Garrett, A., & Holahan, J., (2009). Rising unemployment, Medicaid and the uninsured. The Henry J. Kiser Family Foundation. Retrieved from http:/ www.kff.org /uninsured/upload/7850.pdf Lyons, B., Paradise, J., Perry, M., & Rudowitz, R. (2008). Turning to medicaid and chip in an economic recession: Conversations with recent applicants and enrollees. The Henry J. Kiser Family Foundation. Retrieved from http:/ www.kff.org /Medicaid/ upload/7847.pdf
Parcham, C., & McAndrew, C. (2009). Squeezed! Caught between unemployment benefits and health care costs. Families USA Foundation. Retrieved from http://www.familiesusa.org/assets/pdfs/cobra