Wednesday, January 20

Serious Health Care Reform Question

Jose is in reasonably good health--no pre-existing conditions. Jose is currently enrolled in the Duke University student health care plan, which is okay, but not great. Jose has maintained MA residency and fully intend to purchase insurance there after Jose graduates provided that Jose can't find a job that provides insurance.

Here are Jose's questions. Imagine for a moment that Jose does not have MA residency:

1. Let's say something horrible happens to Jose, like cancer or signing Julio Lugo to a mutliyear deal, between now and graduation. If Jose weren't a MA resident, would Jose still be able to purchase insurance from someone? Anyone? Would my only option be to COBRA my Duke plan until COBRA ran out? And would Jose be fucked once COBRA ended?

2. Jose can get insurance through an employer. Yay! But can the employer's insurance refuses to cover me knowing that Jose is sick?

Jose is not being glib. Thankfully Jose is healthy, but these are situations that are realistic to me, and that Jose doesn't worry about because Jose is, at least theoretically, covered under the MA deal. Jose has been uninsured, not even for a day. Would Jose be certain that if something happened to me, Jose could maintain coverage?

This is NOT intended to be a debate about broader health care reform issues. Rather, this is intended to be a discussion of whether the current system allows, what Jose regards as the absolute minimum consensus. That if you've purchased insurance you're whole life, you should be guaranteed that you can keep it if you get sick.

Jose imagines that right or left, we would agree that if you have maintained coverage at all times, you should not be fucked because you are leaving school or changing jobs around when you get sick. Jose want to know if the current system protects against that.

Aside from COBRA, it is not clear to Jose that it does.


Anonymous said...

Anonymous is an entrepreneur that was recently in school. Anonymous has six more months of COBRA remaining, and then Anonymous is SOL.

At that point, Anonymous would have to get ridiculously expensive independent insurance, except that a back operation leaves Anonymous uninsurable. Anonymous hopes he can then get on the state emergency pool insurance at 2x the normal premium.

The health care debate should be reframed as health insurance access reform. Leaving your job does in fact mean leaving your health care plan, and small-pool plans are horrible -- a huge impediment to independent entrepreneurs and small business owners.

Anonymous said...

You're not fucked when COBRA runs out. The nice thing about COBRA is that if you exhaust your eligibility, you can't be denied coverage post-COBRA due to a pre-existing condition.

If you don't take advantage of COBRA, you're fucked when you graduate.

If you're relatively healthy, private coverage may your best bet when you graduate. Continuing my grad school coverage via COBRA would have been 50% more expensive than a decent private insurance plan.