I was laid off from a program evaluation job in September 2009. I had been working at a grant funded pediatric behavioral and mental health care coordination demonstration project. It was a service that was more expensive up front but usually saved Medicaid money in a few years and social services/criminal justice costs very quickly. We had good results that had been backed up by an external program evaluation.
Our funding when I was on this project was overwhelmingly federal grant pilot funding with a small local match. We needed to transition to regular program funding. That meant we needed a Medicaid waiver for the service that we offered. There was absolutely no discretionary local money in 2009 so we did not receive a waiver. The nerds were let go in order to stretch operational funding. We wanted the kids to be served for as long as possible until a smooth hand-off could be arranged.
Thankfully I lived in Pennsylvania so I had a decent unemployment check. I was eligible for about $1,600 a month. My wife was working part time at the time and earning $1,000 a month and my daughter was nine months old and being very silly and adorable. I received an offer to COBRA our health coverage. We had a $2,500 high deductible health plan for $1,275 a month premium as the risk pool at my former employer was sick as hell. Half of our income would have had to go to just the premium. We were lucky, as part of the stimulus, there was a program that paid for 65% of the COBRA premium. That meant our premium was “only” 16% of our income.
We tried to make that work and we did until January when we switched my daughter to CHIP for $25 a month. CHIP was the best insurance I have ever had. My wife and I got a cheap underwritten policy that offered $500,000 in benefits after a $7,500 deductible with severe coverage limitations. We were getting it to give us some protection if the other person got hit by a bus.
Half of our income for a policy with a deductible equal to our entire monthly income is not an actual choice for insurance. We were trying to stay current on the mortgage, keep diapers on our daughter, and not fall too far behind. And we mostly were able to manage. Once we were both working full time, it took us two years to dig out of the hole that my lay-off placed us in. And that was only because we got lucky. We got lucky that we stayed healthy. We got lucky that we both could find decent enough jobs with decent pay and better advancement opportunities. We got lucky in that we were going to be okay if nothing else happened and nothing else actually happened.
Your money or your life is not a choice.