Insurance options after a lay-off

Fellow Juicer Cain has had a bad week and raises a good question:

So, I just got laid off and my insurance ends in June. Any suggestions on how to get into a new health insurance plan pronto?

Really good question and there are a few options. My first recommendation after yelling at the sky and then getting a cookie (how I dealt with the first 10 minutes of getting laid off in 2009), is to talk to either a broker, an agent or a certified assistance counselor at some point in the next week or two. But here are the basic options:

Go naked
The upside is no premiums. The downside is a lot of risk in case something does go wrong. Meteors happen.

Go underwritten
If someone can pass underwriting, low premiums offer some protection. These plans will become more common in the very near future. The challenge is reading the fine print well enough to make sure that the coverage is actually useful coverage. This includes the Health Sharing Ministries.

COBRA
COBRA allows someone to pay 102% of the premium to hold onto their employer sponsored coverage. Cost sharing is rolled over so you don’t restart paying your deductible. The upside is the transition is smooth as you keep the same exact plan you currently have. The downside is that this is extremely expensive. COBRA may be a good idea for people with significant medical expenses already incurred and expect to incur high expenses in the near future. COBRA, as part of an ERISA plan, is pure community rated. A 21 year old pays the same premium as a similarly situated 64 year old.
An individual losing coverage will receive a COBRA eligibility letter within two weeks of the triggering event. They have two months to elect coverage by paying premiums that retroactively initiate coverage to the date of coverage loss. This is a bit of a one way option where if someone gets a new job with coverage forty five days after the initial loss of coverage, they can effectively be covered by COBRA’s retro-activity provision without actually paying a premium.

ACA Exchange
Job loss and loss of insurance because of a job loss is Qualifying Life Event for the ACA Exchanges. Within 30 days of the triggering event (loss of insurance), you can go on the Exchange and buy a new policy. Depending on your income and family situation, you may be subsidized. Make sure you estimate your annual income as the income from the previous job, any unemployment benefits and some income from a future job so that you don’t get hit with a massive subsidy repayment next year. Out of pocket expenses start off at zero. ACA policies price at a 3:1 ratio for age. Older people will pay more if they don’t buy a plan that is underneath the bench or don’t qualify for subsidies.

ACA plans are probably a better choice for people in good health with little chance of medical expenses for the rest of the year. They are also probably a better choice than COBRA for younger people (<~45ish) than older people due to the age premium ratchet.

Now let’s see if we can help Cain and the rest of the Jackels who are or will soon be looking for work to find work.








Louise Slaughter RIP

My Congresswoman, Louise Slaughter, just died at age 88. I canvassed for her a couple times and have met her once or twice. She was a very good Congresswoman, very powerful within the Democratic caucus.

Typically, you should expect a Dem to win this district by about 15 points, so probably by 20 or more points this fall, given the likely 6 to 15 point swing we will in favor of Democrats. So this is a completely safe seat for 18.








Monday Morning Open Thread: Martin Luther King, Jr. Day

Some history I didn’t know, from the Washington Post“This was Martin Luther King Jr.’s most ambitious dream”:

I was 14 when my parents took my brother and me to Washington to witness the masses gathering there. It was the spring of 1968, and thousands of African Americans, American Indians, Mexican Americans, Puerto Ricans, Asian Americans and poor whites from across the country had made their way to the Mall to protest the thing they all had in common: poverty.

They came by train, bus and car caravans. Some traveled by mule carts. They came from farm towns, big cities, the Appalachian hills and Native American reservations. It was the start of the Poor People’s Campaign.

And they brought the nation’s attention to the crippling effects of poverty — and issued a demand for jobs, training, health care and affordable housing. This was the mission of Resurrection City — the final vision of the Rev. Martin Luther King Jr. and, perhaps, his most ambitious dream.

Once they reached the Mall, they built Resurrection City. It became home for more than 6,000 people; they were there for six weeks. They built 540 tents that resembled wooden shanties, where they lived, worshiped, held meetings, set up Head Start classes and received medical care…

For all its pioneering work, the Poor People’s Campaign failed to realize its aims, in part because there is no simple solution to the nation’s economic ills. Resurrection City brought to light the country’s poverty problem but, befitting its muddy ground, found itself in a social and political quagmire — one that failed to design and construct a strategy for addressing poverty decades into the future.

Today we find ourselves in another pivotal moment in our history — one in which poverty is pervasive and knowledge of its scope scarce. Revisiting the Poor People’s Campaign offers a new vantage point into our shared story, a rich body of knowledge to inform our debates and a model for exposing injustice…

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Apart from community service, what’s on the agenda as we start the new week?








A short review of 2017

Now that I’m back from vacation, I should stop procrastinating and do a quick year in review.

My biggest miss

The first week after the 2016 election, I was convinced that the entirety of the ACA minus the Medicare Advantage cuts was dead.  Medicaid expansion gone. Pre-existing conditions gone. Essential Health Benefits gone. Subsidies gone.

I was wrong.  The individual mandate is gone and Cost Sharing Reduction (CSR)subsidies are a mangled mess of ineffective sabotage.

My most important post

CSR and the limited time fuse

I argued that the threat to terminate payments for CSR subsidies was limited in scope and duration.

The CSR threat loses its ability to blow up the market by sometime in the fall.

This post led me to believe that CSR payments required Republican concessions and not the conventional wisdom of Democratic concessions. From there, it led me to believe and argue that there will never by an appropriation for CSR again.

Proudest moment

Every time every one of you picked up the phone and called.  Every time that we stood for our values.  Every time that we looked at our world and tried to figure out how to make it better and not worse.

End Notes

2017 was a huge transition year for me.

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Open Thread: If It Weren’t for Their Mommy Issues, These Hipsters Would Have No Issues At All

So the grown-ups at Vanity Fair decided, during this (usually) slow-news week, to let their Bright Young Things make a clickbait twitter video about how much they despise that Hillary Clinton woman. If you haven’t already tripped over it, you can click on the link above. I try to remind myself I said some very dumb shit when I was that young… but I was never that irresponsible.


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