Daily Local News (West Chester, PA)

The loss of employer-sponsored health insurance can be a serious concern for older people

- By Sophie Burkholder The Philadelph­ia Inquirer

As of Aug. 30, Michael Kerr thought he would be back to work. When the 52-year-old from Reading was put on furlough from his retail manager position in mid-March, he figured the business would reopen by April, reinstatin­g him and other employees.

But as his furlough dragged on into June, he realized his job loss would become permanent, leaving him without income or his employer-sponsored health insurance.

“I felt like I needed to cover myself in bubble wrap and stay in the house,” he said. “Every ache and pain got a little bit more scary.”

Kerr is one of millions of American workers who have lost their job-based health insurance during the COVID-19 pandemic. The Kaiser Family Foundation has estimated that 27 million Americans could lose their employersp­onsored insurance and become uninsured due to the pandemic. Older workers under age 65 are among the most vulnerable.

Those numbers are staggering to people such as Kerr, who not only have to pay higher premiums for health insurance as they get older but may also have a harder time finding a new job, even when the economy isn’t in a recession. “The closer you get to 60, the more difficult and scary it gets,” he said. “Even by then, you’ve still got five more years to muddle through before getting government assistance.”

Stan Dorn, director of the National Center for Coverage Innovation for the consumer group Families USA, says that loss of insurance among people in the age range of 45 to 64 can be dire, as they often have greater health costs in medication­s or chronic conditions. “These folks are more expensive for an employer than younger adults because the average cost of health insurance is more for them,” he said. And that added cost could be “an extra incentive to get rid of them.”

The loss of health insurance for this group and others could also have a severe impact on the economy, Dorn said.

“When patients don’t come to the hospital because they don’t have insurance anymore, that means revenue dries up,” he noted. “And those hospitals, clinics, and other providers would have to lay off staff.”

Dorn also fears that the economy will continue to see more layoffs into the fall, and with it, more people losing their jobbased health insurance. He thinks that could lead some people to delay or go without the care they need simply because they can no longer afford it.

“Patients with chronic conditions won’t be able to afford their prescripti­ons, or they’ll cut their pills in half,” he said. “We’ll see more people playing Russian roulette with their lives.”

When the Affordable Care Act was passed in 2010, it increased coverage in two ways: by expanding Medicaid for the poor and improving plans for individual­s. For the latter, the act set up a system so that nearly 90% of applicants received subsidies that reduced monthly premiums. The act also increased insurance protection­s for consumers, by banning plans that had lifetime caps on coverage or didn’t cover preexistin­g conditions. More than 20 million people were able to get insurance. But over time, the law’s regulation­s have been weakened, making room for new and cheaper plans with lesser coverage to enter the marketplac­e.

When Kerr realized that his furlough would turn into a permanent layoff and that his benefits would come to an end, he tried to navigate the health insurance marketplac­e on his own. But he quickly grew confused by the discrepanc­ies in cost and coverage between all the available options.

“I almost made a bad decision on a plan that would’ve been more expensive and the coverage a lot less,” he said of a plan through Oscar Health, which started providing coverage in the Philadelph­ia region only this year. “Health care really should be simplified somehow.”

Kerr sought out the help of Young’s Insurance Services, a health and life insurance brokerage agency based in Norristown. James Long, an agent there who frequently works with people in Kerr’s age group, says that people in similar situations often have only two options: extend their employer-sponsored coverage by enrolling in COBRA, or find a plan through the marketplac­e and hope for discounts through subsidies. Long and agents like him are paid on commission, through marketing dollars incorporat­ed into all policies.

Fortunatel­y, Kerr qualified for some subsidies and was able to get an affordable plan through the marketplac­e, saving him from a COBRA option that was beyond his price range. But Long says that for people who are unable to receive subsidies, COBRA tends to be the better option.

Long often sees confusion among clients about how COBRA works. “Lots of people think it’s its own health plan,” he said. “But they’re actually continuing on the same plan from their former employer,

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