Strongly agree that health care coverage is a major concern. We have a long way to go toward an ideal situation.
Sadly, many of the people who are first to be laid off are least likely to have employer-sponsored insurance benefits in the first place (hourly jobs). If they already had ACA-subsidized healthcare plans, nothing really changes for them.
For everyone else, there are some mitigating factors:
COBRA coverage has a grace period following termination. If you opt in to COBRA coverage during this grace period, the coverage is retroactive up to your date of termination. Please check with your insurance, but I believe the minimum grace period is 30 days, although I've personally seen higher numbers listed in my plans.
Many insurers have indicated that they will waive costs for COVID19 testing, and some have even waived copays for COVID19 treatment. I expect we'll see more pressure on this as time goes on.
This is a good time to remind everyone that a job less event triggers a special enrollment period for the ACA. Visit healthcare.gov to evaluate your insurance options. COBRA isn't the only option.
https://web.blockadvisors.com/tax-reform-removes-the-afforda...
just a reminder for the audience though: the Trump admin is currently trying to get the supreme court to rule the entire ACA unconstitutional.
That is a huge understatement. Especially for anyone that needs family coverage. The rates I paid when self-employed were more money per month than my entire paycheck until I was in my late 20's.
We need Medicare for all, desperately. Health insurance should not be tied to employment.
I even had to skip COBRA during one period because that was out of reach.
There is wild disagreement about what a better system would be.
M4A is down to about 26% support as of yesterday. https://i.imgur.com/H9bAwV9.png
[1] https://morningconsult.com/2020/04/01/medicare-for-all-coron... [2] https://thehill.com/policy/healthcare/403248-poll-seventy-pe...
And even though Democrat voters support this the most, the majority of Democratic Presidential candidates this year were opposed to single-payer and pushed some attacks on it that were mostly false (arguing that it removes choice). And a lot of polls on it will mention things many Americans view as negative (a single government run system) and not mention ones that they would view as positive (no out of network doctors, never being uninsured, never switching insurance, no medical billing issues, no healthcare bankruptcies, lower healthcare expenditures, etc.).
[1] https://news.gallup.com/poll/186527/americans-government-hea...
[1] https://morningconsult.com/wp-content/uploads/2020/03/200310... (pdf)
https://news.gallup.com/poll/245195/americans-rate-healthcar...
I've never met a single person who feels their health insurance is good or useful. R=close to zero if the hypothesis is the super majority like theirs.
Have an addiction problem and want treatment? Tough shit. It breaks my heart to think of the number of people who finally got to the point in their lives where they actively sought out help, only to be basically turned away by Kaiser. I would imagine many of those people never got a second chance.
On the other hand, ACA put a dent into their ability to do that.
The non-insurance wing of KP is great, aside from some administrative problems - the main one being that they don't allow some specialists to limit how many patients get referred to them, so they can get overloaded. The alternative is presumably not being able to get a specialist at all, but many of the ones I deal with have waitlists 6 weeks long or longer. Specialist turnover is also quite bad, I've had 4 of my specialists quit in the last 5 years.
No one likes their health insurance. They like having health insurance given the horrifying alternative.
No one (except those on the ACA) gets to really "choose" their insurance either. Your employer offers a few plans. Those can change completely based on their whims.
Why would I care if M4A takes away my health insurance? Please, by all means, take it away! I don't care who pays the bills. In the last 10 years, I haven't been able to keep a primary doctor for a stretch longer than 2 years. Every year for the last 5 years, I have to critically look at my own health needs and try to guess as to what plan on the ACA is going to rob me the least. My taxes would have to go up at least $20,000 a year for it to even approach what I'm spending on a plan that I'm terrified that I might actually have to use.
Do you 'like' Walmart, the company? Or do you just want your groceries and don't really care what the store is called?
It’s a lot easier to reason about on the company balance sheet with the later at the cost of increased complexity and less safety for the employees. But they do love to spin the “triple tax benefits!!!!” (In the case of HSA) to try and convince people this is a great change.
The old Microsoft Premera plan was stupendous as in you never thought about it, (nearly) everything was covered.
https://morningconsult.com/2020/04/01/medicare-for-all-coron...
Edit: looking into it further, I think the WI number is more interesting than I thought given the 2016 election result:
https://projects.fivethirtyeight.com/2016-election-forecast/...
All registered voters supported M4A with ~55% (see POL19) according to a recent poll. I'm not really sure what to do with a twitter image, but I'd be interested in seeing their numbers.
[0] https://www.politico.com/story/2019/09/11/sanders-voters-ele...
https://www.latimes.com/opinion/story/2020-03-06/biden-older...
https://fivethirtyeight.com/features/young-democrats-have-re...
https://www.vox.com/policy-and-politics/2019/11/1/20943879/i...
https://www.nytimes.com/2020/03/13/us/politics/joe-biden-you...
https://www.politico.com/news/2020/03/04/black-voters-biden-...
"already have medicare" theory isn't the explanation.
If Biden runs, Trump wins reelection. Not enough voter support for Biden besides older voters and people of color, younger voters will sit out before voting for Biden in a general election. That's not my opinion, that's what the polling data shows.
[1] https://www.politico.com/news/2020/01/23/joe-biden-black-vot... (“In South Carolina we were taught to vote straight party. You see black people [on the ballot], you see Democrat, you vote straight party. You’re not used to seeing 10 damn candidates in the first place,” added Robinson. The menu of choices plays to Biden’s benefit because he’s a known commodity, Robinson said.)
Young people don't vote, so no one cares what they think. Latino's and African American's will vote for Biden since Trump is pretty damn racist and if they don't, they are basically screwed for another generation. Minorities don't have the luxury of waiting for the perfect candidate like White College Kids can.
> Latino's and African American's will vote for Biden since Trump is pretty damn racist
There are still many Latinx [1] and people of color [2] voting for Trump (or desire a candidate besides Trump and Biden), despite his character. Never underestimate a Cult of Personality.
[1] https://www.theatlantic.com/ideas/archive/2020/02/latino-sup... ("President Donald Trump has done almost everything he can to anger Latino voters. And yet, his support among this crucial portion of the electorate remains surprisingly consistent. After the 2016 election, exit polls analyzed by the Pew Research Center showed that 28 percent of Latino voters supported Trump; today, 30 percent support him.")
[2] https://www.politico.com/news/2020/02/24/blackpac-poll-democ... (Poll: Democrats underperforming with black voters | More than one-third of those surveyed expressed a desire for ‘someone else’ to run for president.)
Put it on a credit card and only make minimum payments, most likely
==The Trump administration has decided against reopening Obamacare enrollment to uninsured Americans during the coronavirus pandemic, defying calls from health insurers and Democrats to create a special sign-up window amid the health crisis.==
[1] https://www.politico.com/news/2020/03/31/trump-obamacare-cor...
To clarify: ACA enrollment is open for anyone who has been laid off. They don't need to wait until the next enrollment period to get health coverage again.
Making ACA open enrollment for an extended period of time would create a perverse incentive for people to avoid enrolling until they feel like they need it. Counterintuitively, this could decrease ACA enrollment rather than increase it.
"Insurers said they had expected Trump to announce a special enrollment period last Friday based on conversations they had with officials at the Centers for Medicare and Medicaid Services, which runs HealthCare.gov enrollment. It wasn’t immediately clear why the Trump administration decided against the special enrollment period. CMS deferred comment to the White House."
==Making ACA open enrollment for an extended period of time would create a perverse incentive for people to avoid enrolling until they feel like they need it. Counterintuitively, this could decrease ACA enrollment rather than increase it. ==
Giving free money to people could create a perverse incentive for people to avoid working, but we just did that. Giving businesses grants for payroll might incentive them not to maintain cash reserves in the future, but we jut did that. I don't see why this would be any different. It's a national emergency, every potential solution should be on the table.
I'm not saying open-enrollment wouldn't be preferable, or that the administration might not be trying to encourage people to enroll, but the option is still open for many, in theory.
Struggle under the weight of the debt, become impoverished and many may become homeless. All the while being told to just find a more lucrative job, like say, coding.
Personally that revolution can't come fast enough. This country has betrayed its constitutional duties to its people for decades (supporting the general welfare, anyone?).
We NEED revolution at this point since it seems both of our two parties are on the same side when it comes to Working Class America.
The framers would more likely to suggest that we NEED a revolution over the expansion of the federal government beyond their limited enumerated powers. They'd also certainly disagree with income taxes as well.
https://www.visualcapitalist.com/the-anatomy-of-the-2-trilli...
I do see $100B paid to hospitals.
Even the small business loans have a provision that they are forgiven only if they keep employees on payroll. That is the difference between keeping insurance and losing it for a lot of people.
Maybe the most obvious and direct way to help those affected. If that was the intent.
Giving cash directly to everyone, sick or poor, is a very different thing. "Expanding Medicare" might help a few.
Paying hospital bills would be exponentially more complex of an operation, and there isn't an organization already set up to administer something like that at this scale.
Sure, but I was talking about helping the infected people.
Yeah, it's more complex, but if it was a priority, it could be arranged. It's not like it has to be done quickly. Bills can be settled months later.
My cynical explanation is that Covid infected do not have a lobbyist at the table when these things are decided.
But, how or why would any infection requirement be necessary or a good idea?
1. The economic toll that is happening is not even remotely limited to those who are infected.
2. We aren't testing everyone and we don't have the resources to do so, so how would you accurately allocate the funds to those who are infected?
3. Those 10 million people who lost their jobs over the last two weeks mostly aren't infected (yet) but still have healthcare needs.
4. Much/most of the population is projected to contract the virus at some point anyway.
The economic toll is also important, but people are dying by the thousands.
I assume many infected will come out of this with 6 digit hospital bills.
We do have the resources to test everyone. Banning most tests is a regulatory decision.
If a goal is to stop virus spreading, encouraging testing should be a primary goal. If people have to pay thousands out of pocket to be tested, that won't happen.
> If we don't agree that the infected are the primary victims, that might be our primary disagreement, and there isn't much left to say.
Most people who cannot pay their health insurance today are not people who are infected. We have 40 times as many people unemployed as we do infected.
> The economic toll is also important, but people are dying by the thousands.
Health insurance or healthcare bills aren't a factor in the death rates of this virus. People won't even be receiving those bills until the virus has either run its course or have killed the patient.
Those who need inpatient care cannot be turned away by law, regardless of insurance status.
Those who do not need inpatient care are being told to go home, regardless of insurance status.
> We do have the resources to test everyone.
This is factually false, and has been repeatedly confirmed by health officials and test manufacturers.
> Banning most tests is a regulatory decision.
.. and it's a decision which the regulators have already undone.
> If people have to pay thousands out of pocket to be tested, that won't happen.
This is not an issue any longer. The test has been determined by HHS to be an essential health benefit which must be covered under ACA compliant public and private insurance plans. State, local, and federal testing facilities are offering the test for free on a widespread basis to those without insurance as well.
Unemployment is a safety net that needs to exist but it shouldn't, IMHO, be the first option to jump to. That's irresponsible unless of course you can't cover your employees at the rate unemployment can--then it's reasonable for everyone's sake.
You should look at supporting employees part time if possible, especially those who have many years association with your business that are valued players. Your first order should be to take care of yourself and those around you, not immediately jump to social safety nets and pass the hardship. Let's re-establish long term employee and employer relationships and get rid if this "everyone's constantly disposable" economic mindset.
If I'm laid off, I'll first look at my savings and hit the job market before I consider driving right into unemployment. I dont want to utilize that unless I need to and my other options fail. I expect businesses to do the same and be responsible contributors to society. If not, let's take a bit more of their stimulus money back and chuck it to other businesses and people that don't run away at the sight of a loss and try to persevere through difficult situations.
This is a great case of “the world doesn’t revolve around you.”
1. Most states only give you a few weeks to apply.
2. You already “pay” for your unemployment several times over during your career through unemployment insurance. Your employer pays this, but they could have paid you more if they didn’t have to.
3. It’s income. You still pay taxes on it. It’s not free money out of nowhere.
Use the tiny social net that you have instead of waiting too late and out of money and having to rely on family or friends.
2. That's pretty much verifiably false. That's fundamentally trickle down economics which everyone knows simply doesn't work. Employers could take that money and increase your compensation. Historically, that hasn't happened. Any breaks given on those expenses temporarily go to an employee then disappear quickly after because there's nothing the business gains by shifting that to labor expenses. The most recent example to look at is the 2017 'Tax Cuts and Jobs Act' which translated to almost no increase in labor rates aside from initial PR compensation packages that people received, forgot about, and continued on with stagnant compensation rates.
3. I never said it's free money, I pointed out in the first paragraph it's not free money. Employees pay a large portion of unemployment as taxes, as I said. Businesses also contribute to that in taxes but the lionshare comes from labor taxes.
Do you have any data on this assertion?
If you manage to work from 25 to 65 at an average of $70k per year, that’s almost a year worth of unemployment.
1. Are unemployment employment benefits only extended to those who have already themselves paid a certain amount in UI taxes AND that amount is the extent of the benefits available to them?
2. If the answer above is no - do you know what % of end up receiving more money in unemployment benefits than they have 'pre-paid' or will 'reimburse' thus a net cost to the system over the course of their living/working lives?
3. What happens to the unemployment taxes paid by people who choose not/never to file for unemployment benefits, even when unemployed? Do those individuals ever get their money back?
4. This line of questioning leads me to wonder why in the US is UI/UB not just directly linked to each individual?
2. Usually, there's a cap for how long you can be on unemployment. You can't be on it forever. You also have to provide proof that you're looking for a job. Some states require signatures from those companies, some just require a list of companies you've applied to and they do their own random validation.
3. Companies pay the unemployment insurance tax on your behalf, and if you're unemployed and don't file, you don't get to use your benefits.
4. 100% agree
I think everyone definitely understands academically that the actuarial models underpinning unemployment collapse in that kind of environment.
>I dont want to utilize that unless I need to and my other options fail. I expect businesses to do the same and be responsible contributors to society.
Here's the issue game theoretically speaking. I'm pretty sure most businesses and people are likely not going to settle on your strategy as being optimal. (Even though, as you've pointed out, it is the communally optimal strategy given the system we have.) I'd imagine most people will opt for the immediate unemployment strategy.
Yes, even if quick and easy way out may not be in their best long term interests.
In the sense of insurance, not claiming unemployment benefits is like laying for insurance and not using it when you have a claim. A personal choice for you to make.
In most cases, you also have to prove you are actively looking for work to get benefits.
However, the recent CARES Act does supplement unemployment benefits from federal taxes.
This is easy to defraud, unfortunately, seen it firsthand in many instances and it's at national scale.
No. Unemployment is a mandatory insurance that all employed people must contribute to based on their income level. It's not a tax. It's an insurance.
> If I'm laid off, I'll first look at my savings and hit the job market before I consider driving right into unemployment.
That's silly, but okay. Would you not tell your home insurance that your house burnt down? I guess you may worry about a higher premium, but you don't need to worry about that with unemployment.
I fear that we will see revolutions in countries where this is not contained, from either a health or economic perspective. An old saying is that you should buy stocks when there is blood in the streets. I hope that doesn't become literal.