ACA Health Insurance Subsidies

Trump to end key ACA subsidies, a move that will threaten the law’s marketplaces, By Amy Goldstein and Juliet Eilperin, October 13, 2017, Washington Post: “President Trump is throwing a bomb into the insurance marketplaces created under the Affordable Care Act, choosing to end critical payments to health insurers that help millions of lower-income Americans afford coverage. The decision coincides with an executive order on Thursday to allow alternative health plans that skirt the law’s requirements…”

Health Insurance and Low-Income Employees

Many low-income workers say ‘no’ to health insurance, By Stacy Cowley, October 19, 2015, New York Times: “When Billy Sewell began offering health insurance this year to 600 service workers at the Golden Corral restaurants that he owns, he wondered nervously how many would buy it. Adding hundreds of employees to his plan would cost him more than $1 million — a hit he wasn’t sure his low-margin business could afford. His actual costs, though, turned out to be far smaller than he had feared. So far, only two people have signed up. ‘We offered, and they didn’t take it,’ he said.  Evidence is growing that his experience is not unusual…”

ACA and Safety-Net Hospitals

Cuts in hospital subsidies threaten safety-net care, By Sabrina Tavernise, November 8, 2013, New York Times: “The uninsured pour into Memorial Health hospital here: the waitress with cancer in her voice box who for two years assumed she just had a sore throat. The unemployed diabetic with a wound stretching the length of her shin. The construction worker who could no longer breathe on his own after weeks of untreated asthma attacks and had to be put on a respirator. Many of these patients were expected to gain health coverage under the Affordable Care Act through a major expansion of Medicaid, the medical insurance program for the poor. But after the Supreme Court in 2012 gave states the right to opt out, Georgia, like about half the states, almost all of them Republican-led, refused to broaden the program…”

States and Medicaid Expansion

Millions of poor are left uncovered by health law, By Sabrina Tavernise and Robert Gebeloff, October 2, 2013, New York Times: “A sweeping national effort to extend health coverage to millions of Americans will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help, according to an analysis of census data by The New York Times. Because they live in states largely controlled by Republicans that have declined to participate in a vast expansion of Medicaid, the medical insurance program for the poor, they are among the eight million Americans who are impoverished, uninsured and ineligible for help. The federal government will pay for the expansion through 2016 and no less than 90 percent of costs in later years…”

COBRA Health Coverage

  • Federal subsidy for COBRA health coverage to expire, By Phil Galewitz, August 30, 2011, Miami Herald: “One of the key consumer benefits of the federal stimulus package – subsidies to help laid-off workers continue their health care coverage – draws to a close Wednesday, raising concerns about how the unemployed will cover those expenses. It’s a dilemma that Holly Jespersen knows firsthand. She lost her job twice in the past two years – both times losing her employer-paid health insurance. But the second time, she paid about $350 a month more for insurance than she had the first time because she didn’t qualify for the subsidy. ‘It made a huge difference for me,’ said Jespersen, 36, of Darien, Conn. ‘I wish I still had it.’ Jespersen was one of millions of laid-off workers to benefit from the federal subsidies for COBRA, a program set up under federal law that allows people who lose their jobs to keep the employer-provided insurance, typically for 18 months, if they pay the entire premium plus a small percentage for an administrative fee…”
  • No more coverage for the unemployed, By Tim Darragh, August 31, 2011, Allentown Morning Call: “Hospital emergency departments may see a continued increase in the number of uninsured people they treat, now that a federal stimulus-funded benefit that helped underwrite health care coverage for the unemployed ended Wednesday. Deficit-conscious members of Congress last year decided to let the subsidy expire, leaving unemployed people who had been getting COBRA coverage the option of paying for it in full, finding a short-term policy or going without health insurance. Enrollment in the program ended in May 2010, and subsidies expired Wednesday for most eligible individuals. There is little doubt that many, if not most, of those people will go uninsured, said Antoinette Kraus, project manager of the Pennsylvania Health Access Network, a coalition of organizations working to expand health coverage for working people and the poor…”

Health Insurance Coverage for Low-Income Adults – Pennsylvania

In Pa., low-income adults soon may be uninsured, By Jenny Gold, February 23, 2011, National Public Radio: “When Paula Michele Boyle first received the letter earlier this month explaining that her health insurance coverage was being terminated, she took it personally, thinking maybe the insurer had discovered something in her history to make her ineligible. But then the Philadelphia resident read on and realized that it wasn’t just her – the entire program, Pennsylvania’s state-funded health plan for low-income adults, was about to be canceled. For Boyle and her husband, Tom, both self-employed cancer survivors who need regular medical care, the news has been unnerving. ‘We were in shock over this,’ Boyle says. ‘What are we going to do now? We need doctor visits and testing.’ Nearly 42,000 people who participate in the program have received similar notices. Another 494,787 people had been on the waiting list, hoping to get such coverage…”

States and Health Care Programs

States must cut health care programs, By Julie Appleby, February 10, 2011, USA Today: “Lisa Huff says the state-funded Disability Lifeline program in Washington state has lived up to its name, helping her get counseling for depression, treatment for diabetes and support for her ultimate goal: getting a job. Now the program for low-income, temporarily disabled residents is one of many on the chopping block in Washington, where lawmakers face stark choices in closing a projected shortfall of $4.6 billion in their next two-year budget, 2011-13. At risk are some of the very programs seen as national models: a state-subsidized Basic Health insurance plan for low-income residents who don’t qualify for federal help – the first of its kind when it began 20 years ago – and services that help seniors and the disabled stay out of nursing homes, as well as insurance for 27,000 undocumented children…”

State Budget Cuts – California, Pennsylvania

  • Deep social services cuts outlined in California, By Jesse McKinley, January 10, 2011, New York Times: “Workers were removing the ornaments from the Christmas tree at the Capitol here on Monday morning, and much the same mood filled the legislative chambers as Gov. Jerry Brown unveiled his Grinch-like budget. It included $12.5 billion in spending cuts, with a 10 percent cut in take-home pay for some state employees and deep reductions in social services. He also suggested a five-year extension of a bundle of taxes, a plan that requires voter approval, setting the stage for a potentially contentious special election in June. The budget is meant to address an estimated $25.4 billion deficit, just the latest shortfall for a state that has experienced a drumbeat of bad economic news in recent years. But Mr. Brown, who took office last week, cast the blame even further, saying the state’s leaders had spent the last decade balancing their books with ‘gimmicks and tricks and unrealistic expectations that pushed this state deeper and deeper into debt.’ But that period, Mr. Brown repeatedly emphasized, was over…”
  • Pennsylvania subsidized health insurance for low-income people to end, By Don Sapatkin, January 12, 2011, Philadelphia Inquirer: “Pennsylvania’s subsidized health insurance for low-income working people will likely end next month, officials on Gov.-elect Tom Corbett’s transition team said Tuesday, leaving more than 40,000 people with less palatable options and dashing the hopes of more than 400,000 on the waiting list. ‘AdultBasic is not sustainable,’ said Kevin Harley, a spokesman for the transition, referring to the insurance program that began eight years ago under Gov. Tom Ridge, a Republican, and was expanded by outgoing Gov. Rendell, a Democrat. Staff for the incoming and outgoing governors traded accusations Tuesday about who was responsible for the program’s demise, but both agreed that the money – a combination of tobacco-settlement revenues and donations from the state’s four Blue Cross plans – would run out around Feb. 28 for the fiscal year that ends June 30, and that no good alternative was in place…”
  • Corbett team negotiates health care for working poor, By Brad Bumsted, January 11, 2011, Pittsburgh Tribune-Review: “Leaders of Republican Gov.-elect Tom Corbett’s transition team said yesterday they worked out a plan with insurance companies to continue providing coverage to the working poor, but at significantly higher premiums than people pay now. Corbett’s team charged that the outgoing administration of Democratic Gov. Ed Rendell unnecessarily delayed notification to people in the adultBasic program and failed to live up to an agreement to provide state money to extend the program. Coverage under the program expires Feb. 28 because of a shortage of money. About 45,000 people receive adultBasic coverage…”

Long-Term Unemployment

  • Without COBRA subsidy, health care would require 79% of jobless benefits, By Deb Price, June 6, 2010, Detroit News: “Newly laid-off workers in Michigan face average monthly COBRA health care premiums of $1,019, which would gobble up more than three-quarters of their jobless benefits, according to a report released today by an advocacy group urging Congress to help. ‘The elimination of COBRA subsidies means that people losing their jobs will also lose their health care coverage,’ said Ron Pollack, executive director of Families USA. ‘Such a loss of health coverage flies in the face of the recently enacted health reform legislation that is intended to expand health coverage to tens of millions of people.’ The House passed a slimmed-down $102 billion jobs bill May 28 that dropped a proposal to extend eligibility for the federal COBRA subsidy through the end of the year. The result is workers who lost their jobs before June 1 get the COBRA health care subsidy — a 65 percent subsidy of health care premiums for up to 15 months. But those laid off after June 1 aren’t eligible…”
  • Long-term jobless facing longer odds in job market, By Jeannine Aversa (AP), June 6, 2010, Wilmington News Journal: “If you lose your job these days, it’s worth scrambling to find a new one — fast. After six months of unemployment, your chances of landing work dwindle. The proportion of people jobless for six months or more has accelerated in the past year and now makes up 46 percent of the unemployed. That’s the highest percentage on records dating to 1948. By late summer or early fall, they are expected to make up half of all jobless Americans. Economists say those out of work for six months or more risk becoming less and less employable. Their skills can erode, their confidence falter, their contacts dry up. Their growing ranks also will keep pressure on Congress to keep extending jobless benefits, which now run for up to 99 weeks. Overall, the economy has created a net 982,000 jobs this year. But for Jeff Martinez and the record 6.76 million others who have struck out for six months or more, their struggles are getting worse, not better…”

COBRA Subsidy and the Rate of Unisured

Many who lost jobs used COBRA subsidy, kept insurance, By Sandra Block, May 10, 2010, USA Today: “A new Treasury study says the federal COBRA subsidy, included in last year’s economic stimulus package, may have slowed the growth in the number of uninsured Americans during the recession. The study estimates that up to a third of eligible unemployed workers have taken advantage of the subsidy, which covers up to 65% of the cost of continuing a former employer’s health care coverage for up to 15 months. Under COBRA, workers who leave their jobs can continue their former employer’s health insurance coverage for up to 18 months. Ordinarily, though, they must pay the entire premium, plus administrative costs, making COBRA unaffordable for most people who are out of work…”

Health Care Reform and the Uninsured

Benefit for uninsured may still pose hurdle, By Roni Caryn Rabin, April 19, 2010, New York Times: “William Mann of Pittsburgh earns just enough to get by. He is 46, doesn’t own a car, hasn’t taken a vacation in three years and hasn’t had health insurance for most of his adult life. He is just the kind of person who should benefit from the health care overhaul, and he is, in fact, eligible for heavily subsidized insurance that will cost him an estimated $1,845 a year, while the government contributes about $2,756. But Mr. Mann says he still can’t afford it. He lives too close to the edge, and won’t be buying insurance, even though he will face a fine under a provision called the individual mandate, which penalizes most Americans who don’t buy coverage starting in 2014. The requirement is one of the most controversial aspects of the overhaul…”

Health Care Reform in the US

  • House passes health-care reform bill without Republican votes, By Shailagh Murray and Lori Montgomery, March 22, 2010, Washington Post: “House Democrats scored a historic victory in the century-long battle to reform the nation’s health-care system late Sunday night, winning final approval of legislation that expands coverage to 32 million people and attempts to contain spiraling costs…”
  • Republicans vow repeal effort against health bill, By David Herszenhorn, Robert Pear and Carl Hulse, March 22, 2010, New York Times: “As jubilant Democrats prepared for President Obama to sign their landmark health care legislation with a big ceremony at the White House, Republicans on Monday opened a campaign to repeal the legislation and to use it as a weapon in this year’s hotly contested midterm elections…”
  • Legal and political fights loom, By Jeff Zeleny and Sheryl Gay Stolberg, March 22, 2010, New York Times: “The battle over health care is poised to move swiftly from Congress back to the country as Democrats, Republicans and a battery of interest groups race to define the legislation and dig in for long-term political and legal fights…”
  • Texas: Most uninsured, most votes against bill, By Dave Michaels, March 22, 2010, Dallas Morning News: “The state with the most to gain from a health insurance overhaul was also the state with the most lawmakers who voted against the bill on Sunday. Twenty-one of 32 lawmakers from Texas, including 20 Republicans, voted against the measure. The opponents said the legislation was overwhelmingly unpopular in their districts, although it would offer insurance to more than half of Texas’ 6 million uninsured…”
  • California stands to gain most from health bill, By Victoria Colliver, March 22, 2010, San Francisco Chronicle: “The stakes are high for Californians when it comes to the health care overhaul, mainly because the coverage problems in this vast state are so large. With a new UCLA study estimating that more than 8 million Californians, or nearly 25 percent of the population, lack health coverage, many health experts say California will be impacted more than other states by the reform legislation…”

COBRA Subsidy Extension

Recipients hail Cobra subsidy extension, By Victoria Colliver, December 22, 2009, San Francisco Chronicle: “Christmas came a little early for unemployed people who’ve put health insurance at the top of their wish list. Congress, under pressure to provide additional help for people who have lost their jobs and health benefits, passed legislation to extend federal subsidies to help people pay for their former employer’s health insurance. Lawmakers also agreed to extend the eligibility period to sign up for assistance. As part of the stimulus bill passed in February, the federal government subsidized 65 percent of the cost for unemployed people who opted to continue their employer’s health insurance coverage. A person can pay to stay on his or her former employer’s group policy – generally for a maximum of 18 months – through the Consolidated Omnibus Budget Reconciliation Act, a federal law better known as Cobra…”

Extension of Jobless Benefits

A plea to Congress on jobless benefits, By Erik Eckholm, December 7, 2009, New York Times: “State labor officials and worker advocates on Monday appealed for quick Congressional action to extend emergency unemployment benefits and to renew health insurance subsidies for the long-term jobless. Prolonged unemployment insurance, passed this year in the stimulus act, expires this month, and officials estimate that more than one million workers will see benefits end in January if Congress does not act. The health subsidies, under which the federal government pays 65 percent of insurance costs under Cobra for up to nine months, have already expired and are not available to the newly unemployed, who will have to pay family premiums averaging $1,100 if they want to keep their existing health plans…”

Unemployment and COBRA Health Insurance Subsidy

  • COBRA subsidies begin expiring for the unemployed, By Kathy M. Kristof, November 30, 2009, Los Angeles Times: “Millions of unemployed Americans face the prospect of a huge increase in health insurance costs, thanks to the looming expiration of a government subsidy. The American Recovery and Reinvestment Act, passed in February, launched a temporary government program to subsidize the often crippling cost of buying health insurance through a former employer’s plan after a layoff. However, the so-called COBRA subsidy was designed to last no more than nine months for each person who was unemployed. Hundreds of thousands who got this subsidy when it was first made available in March are slated to roll off the program today…”
  • Expiring health insurance subsidy imperils laid-off Americans, By Tony Pugh, November 27, 2009, Kansas City Star: “Just before Don Hall and his family left town for Thanksgiving, the laid-off manufacturing supervisor from Castalia, Ohio, wrote a $763.81 check to his health insurance company for his December payment. He had paid $237 in November, but the big increase wasn’t due to rising health costs or a catastrophic illness – and it wasn’t an isolated incident. Hall, 56, is among an estimated 7 million unemployed Americans who get a federal subsidy to help them buy health insurance under legislation known as the Consolidated Omnibus Budget Reconciliation Act…”
  • Health insurance subsidy for jobless to phase out, By Philip Walzer, November 28, 2009, Virginian-Pilot: “A federal subsidy that has saved unemployed people hundreds of dollars a month in health-insurance costs will begin phasing out next week. The COBRA program allows many people out of work to continue health coverage for at least 18 months through the plans they had with their employers. They normally have to pay the full cost of the premiums, but a COBRA subsidy in the federal stimulus package signed in February by President Barack Obama slashed their costs by nearly two-thirds…”
  • Insurance aid for jobless to expire Tuesday: Thousands in R.I. will begin to lose subsidy, By Cynthia Needham, November 28, 2009, Providence Journal: “Beginning Tuesday, the first of thousands of unemployed Rhode Islanders will exhaust a federal stimulus subsidy that has helped them afford temporary health insurance. A provision within the American Recovery and Reinvestment Act allows a 65-percent discount on COBRA, the law that lets laid-off workers purchase group health benefits though their former employer for up to 18 months…”

Health Care Reform and the Uninsured

  • Proposing a public health option as a ‘safety net’, By Robert Pear, September 19, 2009, New York Times: “Senator Olympia J. Snowe, a pivotal Republican, described on Saturday the changes she wanted to see in a comprehensive health care bill to make insurance more affordable, and she proposed a government insurance company as a possible backup to the private market if coverage remains too costly. Ms. Snowe’s proposal was among 564 amendments filed in the last couple of days by members of the Senate Finance Committee, which plans to take up the legislation this week as the struggle over health care enters a critical new phase…”
  • How health overhaul would affect the uninsured, By Christopher Weaver, September 21, 2009, National Public Radio: “How many Americans are uninsured? According to the Census Bureau, in 2008, more than 46 million Americans – about 15 percent of the population – did not have health insurance. Because of the recession, many experts believe the number is now larger. Who are the uninsured? Income is a strong factor in identifying the uninsured. About two-thirds of uninsured Americans earn less than twice the federal poverty level, which is $22,050 for a family of four. Almost 25 percent of the uninsured are poor enough to be eligible for Medicaid but are not enrolled…”
  • Uninsured take a toll on all North Texans, By Robert T. Garrett and Jason Roberson, September 20, 2009, Dallas Morning News: “Up to one-third of Dallas-area residents don’t have health insurance, and the number is rising. Everybody in North Texas pays the cost, through taxes and higher insurance costs – as much as $1,800 per family. Illegal immigrants pump up the numbers. But even if there weren’t any here, Texas still would virtually lead the nation in percentage of residents without health insurance, according to both conservative and liberal researchers. And Dallas County is close on Harris County’s heels as the major metro county with the lowest rate of health insurance coverage…”

Health Care Reform and Subsidies

For Marylanders, insurance affordability will depend on subsidies, By Kelly Brewington, September 7, 2009, Baltimore Sun: “Even if lawmakers can agree on how to overhaul the nation’s health care system, the hope of universal coverage could crumble if individuals can’t afford their share. Take Howard County. Less than five months into an innovative program to give low-income people access to medical care for as little as $50 a month, nearly one in 10 participants is at risk of being cut off because they can no longer afford the cost. Howard officials say their fledgling program, called the Healthy Howard Access Plan, provides a cautionary lesson for federal policymakers battling over how to re-imagine the nation’s health care system and extend insurance to some 47 million Americans. While the major congressional proposals would require that nearly everyone have insurance or pay a penalty, low-income people could qualify for subsidies to help cover the cost of premiums. But lawmakers are wrangling over who would get financial help – and how much. If the subsidies fall short, millions of Americans could continue to struggle without health insurance, say advocates for the uninsured. Besides, if people in Howard County – among the richest localities in the nation – can’t manage $50 a month, how could those struggling elsewhere afford the plans under consideration in Washington that would require a much higher out-of-pocket cost?…”