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The Affordable Care Act has emerged as a sticking point in the presidential campaign. Democratic vice presidential hopeful Kamala Harris has said that the Trump administration, aided by a new Supreme Court bench, could invalidate Obamacare and its requirement that insurance companies cover preexisting conditions. Vice President Mike Pence said the administration would not let that happen but has declined to say how.
With nearly 12 million people on unemployment and so much health care coverage tied to jobs lost to the pandemic, what are the available options for coverage? Colleen Carey, assistant professor of policy analysis and management at Cornell University, joined “Marketplace Morning Report” host David Brancaccio to discuss. The following is an edited transcript of their conversation.
David Brancaccio: A lot of talk, in the campaign, especially, about the possibility of losing preexisting conditions if the Supreme Court rolls back the Affordable Care Act or gets rid of it. In the depths of the pandemic, if people have lost jobs — a common occurrence these days — there are different options. This Affordable Care Act does allow you — if you’ve lost the job, if there’s been a life event — to enroll.
Colleen Carey: Upon the loss of a job, you have a couple of options. One would be to continue employer-sponsored insurance through a spouse if that option is available to you. The fact that you lost your job means you could enroll as a spouse on your spouse’s plan whenever you need it.
Another option would be to pursue Affordable Care Act individual market coverage. So that you can enroll whenever you lose your job, that’s a “qualifying event,” they call it. That would bring you coverage that looks not very different from your employer-sponsored insurance if you qualify under your state’s income limits — which, you know, you very well may if you’re on unemployment insurance — and your state expanded Medicaid under the Affordable Care Act.
Brancaccio: Medicaid, Affordable Care Act, maybe you have a spouse who’s still employed and has that coverage. There’s also the COBRA system where you can continue the insurance from your previous job. That’s awfully expensive, though, right? Because people have to bear the full cost of that coverage.
Carey: Exactly. It’s very expensive. And, of course, that new expense comes at a time when families are dealing with the lost income from a job that that has vanished. So it can be very hard for families to find those monthly premiums.
There is one weird trick that I always like to make sure people are aware of for COBRA, which is that you can actually enroll in COBRA and backdate your enrollment all the way back to the time you lost your job. So what this means is, you know, you could roll the dice and go without coverage for a little bit. If you experienced an adverse health event, like a hospitalization or needed some expensive care, you could enroll in COBRA and say that you want the coverage to begin back on the day that you lost your job.
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