When a Chicagoan Loses Her Job and Her Coverage

A 60-year old neighbor lost her job in downtown Chicago due to the pandemic and, as of today, her coverage. Like nearly half of all Americans, she relied on her employer for health insurance. Here’s her story.

How many options did she have? Two. She was eligible for 1) COBRA through her former employer and 2) health plans on the federal marketplace. Her financial resources disqualified her for Medicaid.

What about Medicare? No. Medicare requires most people to be 65 years old. “Now I understand what it would mean if it were available to people who were 60 years old,” she said.  

What about pre-existing conditions? Yes. She has a health issue that requires a specialist at a major medical center. The specialist is an in-network provider with her current (for-profit) insurance carrier.

Who has helped her? Nobody. The company’s Human Resources department was overwhelmed with the effect of the pandemic on the business and its employees. It provided a one-page explanation of COBRA. 

How were the health benefits? Fair. Like many employers, the company had limited expertise. “My team met to analyze the health plan options during open enrollment because HR did nothing more than a PowerPoint.”

What did she do? COBRA. She chose it because it was easy, but it was also expensive at $600 per month. “It’s all too much right now given the need to find a new job and a new apartment.”

What’s next? Shopping. First, for a job. Then, in November—if she’s still unemployed—for coverage on the federal marketplace for 2021. She was nervous about finding a plan with her specialist that she can also afford.

If my neighbor had lived in any other advanced country—Canada, Germany, Switzerland, UK—she would still be covered. In countries with some form of universal coverage, not one person is both unemployed and uninsured.

“Employer coverage isn’t all it’s cracked up to be.” No, it is not. Maybe it’s time to think about a future where employers have no role in health insurance. In the meantime, she’s Mastering Health Insurance.