I was laid off from a program evaluation job in September 2009. I had been working at a grant funded pediatric behavioral and mental health care coordination demonstration project. It was a service that was more expensive up front but usually saved Medicaid money in a few years and social services/criminal justice costs very quickly. We had good results that had been backed up by an external program evaluation.
Our funding when I was on this project was overwhelmingly federal grant pilot funding with a small local match. We needed to transition to regular program funding. That meant we needed a Medicaid waiver for the service that we offered. There was absolutely no discretionary local money in 2009 so we did not receive a waiver. The nerds were let go in order to stretch operational funding. We wanted the kids to be served for as long as possible until a smooth hand-off could be arranged.
Thankfully I lived in Pennsylvania so I had a decent unemployment check. I was eligible for about $1,600 a month. My wife was working part time at the time and earning $1,000 a month and my daughter was nine months old and being very silly and adorable. I received an offer to COBRA our health coverage. We had a $2,500 high deductible health plan for $1,275 a month premium as the risk pool at my former employer was sick as hell. Half of our income would have had to go to just the premium. We were lucky, as part of the stimulus, there was a program that paid for 65% of the COBRA premium. That meant our premium was “only” 16% of our income.
We tried to make that work and we did until January when we switched my daughter to CHIP for $25 a month. CHIP was the best insurance I have ever had. My wife and I got a cheap underwritten policy that offered $500,000 in benefits after a $7,500 deductible with severe coverage limitations. We were getting it to give us some protection if the other person got hit by a bus.
Half of our income for a policy with a deductible equal to our entire monthly income is not an actual choice for insurance. We were trying to stay current on the mortgage, keep diapers on our daughter, and not fall too far behind. And we mostly were able to manage. Once we were both working full time, it took us two years to dig out of the hole that my lay-off placed us in. And that was only because we got lucky. We got lucky that we stayed healthy. We got lucky that we both could find decent enough jobs with decent pay and better advancement opportunities. We got lucky in that we were going to be okay if nothing else happened and nothing else actually happened.
Your money or your life is not a choice.
rikyrah
PREACH!!
TELL IT!!!!
Tom
Damn straight!
SFAW
What rikyrah said.
Also: I don’t know if that’s an original line — I guess it doesn’t matter — but that line (or a slight variant) should be SHOUTED (figuratively speaking) by every Dem Senator, every damn day, until McConnell (and that moron Cornyn with him) gives up.
Every day.
Redshift
I’ve been lucky enough with employment coverage that never having to deal with COBRA again was one of the biggest benefits of the ACA for me.
In the late 90s, a company I worked for went out of business, and I found out how badly they can try to screw you if your former employer isn’t around to fact-check the insurer on what your coverage was.
First our insurer offered us a plan that covered only hospitalization (they’re supposed to give you the equivalent of your former coverage, which had been quite good.)
Them they basically did individual underwriting instead of giving us the price from the group coverage. My wife had a chronic health condition, so that was utterly unaffordable. I got my local insurance commissioner involved, and she said she’d never seen anything so outrageous. She was still fighting them when I finally got a new job.
Fester Addams
Yes but don’t forget the joy you get from knowing that your situation is helping to reduce billionaires’ taxes.
satby
Honestly, you just recapped the insurance history of my entire life, but as a single parent I was always the sole income (ex was a deadbeat), so there was no way I could ever afford COBRA. About 1/2 of my entire life has been spent uninsured with a pre-existing, usually untreated chronic illness (asthma). Sheer luck and pure cussedness that hasn’t killed me already. Watching other people slowly realize they could be in those shoes has been schadenfruedetastic, in a sad way.
DanF
Yup. Most of us have had those unplanned moments where we’re making a leap with no safety net. Oddly, it doesn’t feel like the freedom the GOP makes it out to be. More of a nauseous, oh shit kind of feeling.
Major Major Major Major
Republicans should call their legislation the Jack Benny Plan.
Villago Delenda Est
This is where grifting asshats always fuck up; they get greedy and go after the rich, and discover that with them, there are consequences for theft.
Jado
Your money or your life is always the only choice ever given by Republicans. We are not people – we are walking talking dollar signs, and if they can reduce us, they get to stuff their wallets with the dollars bleeding out of us as we die.
Ohio Mom
Ohio Dad got laid off back then too, and the stimulus program that helped pay for COBRA is very fondly remembered.
Tom Levenson
Preach it.
I’ve had a couple of dances with Cobra — once when young, single and cheap, once when my wife and I decided to go freelance at the same time (oy!). Getting back on employer health care has made middle age possible.
maurinsky
I have never been able to afford COBRA when I left one job and went to another. We always gambled that we would make it through the trial period of the first three months of work. We were lucky to never have any health crises during those time periods.
dnfree
Thanks for sharing, and very true. My chiropractor told me they are paying $2500 a month for a high-deductible family insurance plan under the ACA. As he says, not everyone can afford $30,000 a year and then on top of that a high deductible for each family member. He still supports the concept but for those not eligible for a subsidy or for the Medicaid expansion, it isn’t functioning like “real” insurance. What the Republicans are proposing is far worse, but the ACA certainly needs fixing as well. I’m sure all the uncertainty for insurers is part of the problem, as well as effective removal of the individual mandate.
piratedan
well, to be honest, I simply think that most rank and file GOP people simply wanted to punish the moochers off of the government teat. They’ve been fed a long lie game from the people over at Faux News and Rush Limbaugh and InfoWars that ALL immigrants are out to steal from them, directly, because of your taxes, an education, your jobs, government handouts that when it comes to things like health care, they think its all one and the same. When confronted with actual human beings and actual real life encounters most of them consider that an exception, doesn’t fit into the all, so they can file safely file that way as an anomaly.
The thing is, a good many of the GOP politicians know that the Faux News propaganda channel is a lie but just let it go because it gives them power, or at least the perception of power, but wielding it to suit those that put them into place, is a lose lose choice, either they do the right thing and save healthcare for people and sustain the wrath of their most rabid followers and get threatened by a well funded primary opponent and lose the backing of their well financed patrons, or screw people over, risk the gauze being dropped from the eyes of the general population and get kicked to the curb that way…
one allows you to possibly sleep at night if you have any redeeming qualities left about your person… the other allows access to the GOP gravy train…
the third option, with the able assistance of Putin, now allows you to screw over people and get re-elected…
Chris
So much this.
grandpa john
I spent 28 years teaching in public high schools,.I also received credit for my two years in the navy which gave me the 30 needed for retirement. For the last 10-12 years of my career , there were 2 things that kept me going, The retirement pay and the BCSC state employee health insurance plan that continued until I reached medicare and I continued on with it as my supplementary medicare insurance I just turned 80 and have had this extra coverage for me and my wife for all these years. I retired at age 54 and was self employed until age 75 , but I knew I had coverage. My medicare supplement pays every thing that medicare doesn’t.
Calming Influence
I was laid off from a biotech job in 2012 with 4 months salary and health insurance coverage. After 4 months cobra was ~$730 for me only; my wife was covered through her job and adding me would have cost more. The cobra option took me to one month before ACA kicked in. I remained motionless for that month, wore a mask, and washed my hands 12 times a day.
Seriously, $730 per month. Not so I could go to the doctor for a sniffle and hand over a $25 copay, but so that if I was diagnosed and died from a glioblastoma (cough McCain! cough), the treatment costs wouldn’t mean that my wife would lose the house and have to move into homeless shelter.
It’s a protection racket, and the 1% don’t want it to stop.
Chris
@piratedan:
I think there are less and less of those, actually. Fox News has been around for twenty years. The GOP is increasingly filling up with politicians whose entire adult lives has been lived within that bubble. Even if they know on some level that it’s not the whole truth, it’s still their principal frame of reference.
Dave
Something libertarians and pseudo-free market fetishists fail to understand or recognize; at least until they are faced with that choice.
gvg
people can’t stay healthy by will power. that’s what those yelling self sufficiency seem to imagine. I think most people are afraid of seeing how powerless they are against chance.
Major Major Major Major
@Chris: this is true and very important. The tea party wave brought in a lot of politicians who grew up steeped in the stuff they feed the idiots, and they actually believe it. They don’t see it all as lies to enable tax cuts and dog whistles to attract the racists; they really do think it’s true!
Chris
@gvg:
“They can eat healthy and exercise! They can stop sleeping around with so many women! They can stop stop smoking and drinking and doing drugs! Why should my money have to pay for your rehab, or your AIDS treatment, or your cholesterol treatment, when I’ve been responsible and healthy all this time?”
gvg
@Chris: yes, that’s whats been so frightening lately, the last 10 years I have realized these kooks being elected are not knowingly lying, they have been raised by a psycho TV channel. They represent a large group of kook voters…lots of them out here with us, looking just like us…….
Chris
@Major Major Major Major:
Also related to this: Adam’s repeated concern that Congress is increasingly filled up with people who have literally never passed a budget, because Congress has been (by their doing) in permanent crisis mode for their entire time in office.
Major Major Major Major
@Chris: this is one of a whole raft of things, like Trump’s incompetence, that are momentarily useful but also doing significant long-term damage to our democracy. They have to be stopped.
West of the Rockies (been a while)
@piratedan:
It won’t happen, but maybe a massive change to political laws would help. Term limits. Limit donations by corporations and individuals. Do away with PAC’s. Decrease the pay of Congress; limit its perks to something less generous for life. Somehow make it much harder and less desirable for millionaires to want or get the job.
That’s my starting suggestions. Probably utterly unworkable.
Hal
I work on the administrative side for a major cancer center and we have patients come in all the time who have coverage via the ACA. Either exchange or expanded medicaid. I always want to scream when I see some old high school friend or former co-worker post on Facebook how horrible Obamacare is because of free-dumb, or the former co-worker who claims the best he could get in Georgia was an 1,800 dollar a month plan. I’ve engaged a few times when he’s posted flat out lies (just recently it was how millions lost their insurance, something he’s been challenged on before), but nothing I or anyone else has said will move the guy. He’s a big church goer who also believes there use to be a network of charities that provided health care for people before big government stepped in. At the end of the day, these people just need to be saved from themselves, but they are never going to change their minds unless something happens to them directly.
FlipYrWhig
@West of the Rockies (been a while): Wait, wouldn’t decreasing the pay and perks of Congress make it _more_ the exclusive province of people who were already millionaires and didn’t need the salary?
Matt
@Hal:
The real question becomes: when aren’t they worth saving? A drowning person may eventually have to be abandoned to the water if rescuers can’t get near them without being drowned as well:
https://en.wikipedia.org/wiki/Instinctive_drowning_response
David Anderson
@West of the Rockies (been a while): I don’t like term limits because it removes any institutional knowledge of how the system is run and why decisions were made. Rules that get rid of John Lewis are probably not optimal rules if we are concerned about how we treat civil rights for instance.
As it is, Congress has intentionally cut off its information sources (Gingrich’s first few moves to cut the Office of Technology Assessment) and dramatically reduced staff. I have talked to Congressional staffers who mean well and know jack shit about the seventeen things that they are supposed to advise their member on. We already have a minimally informed Congress. Instituting term limits just means we have no institutional knowledge in the government and all of it is on K Street.
Drunkenhausfrau
I wish everyone on the intertubes could read this and understand it. Sigh.
dmsilev
@West of the Rockies (been a while): Term limits and decreasing the pay/perks of Congressmen would make the problem worse, not better. You’d get even more rich people, who are even deeper under the sway of professional lobbying groups.
Immanentize
@Hal:
In some ways, there is some truth to this. The motto of Mt. Auburn Hospital in Cambridge MA used to be: “Man tends, God mends.” So if by health care he means chicken soup, health care for barter, and prayer circles — well he might be right.
But of course that is all so much bullshit now. No network of charities has the resources, knowledge or reach to provide health care for people, let alone advance science in health services and care. And even those who have some reach may just screw the pooch by becoming weird and political — see, Komen for the Cure.
Chris
@David Anderson:
Also, isn’t removing term limits basically begging for a transfer of more power to the behind-the-scenes professional political operators? A Tammany Hall type setup with a revolving door of politicians who’re only the public face of the enterprise, while the machine survives forever and the real power is with unelected bosses?
Calming Influence
Term limits means instead of fraction of the house being filled with the nuts du jour, you have the whole house filled with the nuts du jour.
Immanentize
@David Anderson: I think there are some term limits that make sense. For example, I think that a term of 25 years for a supreme court justice (i.e. one generation) might be a good thing. It would allow Justice terms to be spread out over various Presidential terms which would increase the likelihood that any president might get a pick (in fact, you could design it that way) which might decrease the current partisan fighting…. Lifetime tenure is not the only way to insulate the Judiciary and keep them independent.
Also, age limits are not a bad thing for Congresscritters. Maybe 75. Not a term-limit per se, but an acknowledgement that things should not be placed in amber. Again, it would allow for more orderly transitions.
Elizabelle
@Immanentize: 25 years for the Supreme Court is a good idea.
Re term limits: it helped a lot when Congress decided to term limit the Committee chairmanships. Got rid of some of the folks hanging on by their toenails, because it was power.
Perhaps one idea would be 5 terms in Congress, and then you can’t succeed yourself, although you can absolutely run again. After one or two terms out. Would allow a Henry Waxman to be returned to office (because he truly was a public servant).
Major Major Major Major
@dmsilev: yeah, the less you pay congressmen the more likely you are to only get people who can already afford to run for office and relocate across the country and hold down two residences.
Calming Influence
@Immanentize: Grandpa John (above) might object to the 75 year age limit (he just turned 80).
I would be a lot more comfortable with a long 25 – 30 year scotus term limit Than an age limit.
Yarrow
Immanentize
@Calming Influence: First, I do propose 25 year terms for Supreme Court Judges. It would take a while to finalize, but if every President was allowed to appoint one Justice in their first year as President (thus aligning the public mandate with the pick) in 32 short years, every justice would be on the new system. Interim appointments could be made the old fashioned way, but only for the remainder of the Justice’s 25 year term.
The fact that people live beyond the age of 75 does not mean they have the right to hold public office. In Massachusetts, at least the appointed Judiciary must retire at 70. Not true for elected offices. I pray to Dog — absent some magnificent scientific breakthroughs — that I am not at 80 arguing for how great it would be to have me in a position of authority.
TenguPhule
That was 2016, David.
The new 2017 GOP motto is “Your money AND your life.”
MoxieM
(a) I’m so glad you’re OK plus adorable daughter (I’m biased that way, I have one who is now 25 … ) (b) I so admire that you clearly bring compassion from your own close shave into what you do here, and probably in your other work. Thank you. (c) yeah, I’m at the close to end of my working life and bad health-luck has caught up with me. I just hope I can keep finding shitty jobs that come nowhere near my experience or education (ha! pink collar ghetto…) or, something. Money/life–feh.
Anyway, thank you.
TenguPhule
@Major Major Major Major:
Well, yes. Of course, the Republicans are doing their damn best to ensure there are no legal remedies left to address them.
“So what are you gonna do about it?”
Brachiator
@West of the Rockies (been a while):
Well, Bernie Sanders is continually honking the “grass roots” fantasy, which I suppose envisions that salt of the earth types and not millionaires will run government.
California has term limits. What has resulted is a fixed game of political musical chairs, in which party big wigs largely control who runs for the limited supply of open seats. Veteran name politicians get first pick and their designated heirs, sometimes relatives, sometimes former staffers get priority afterwards.
Also, the millionaires and billionaires are often satisfied with being the power behind a chosen politician. No matter what reforms you put in place, it requires vigilance to keep politics honest.
Karen
My step daughter had Cystic Fibrosis; I spent nearly 10 years dealing with over a dozen different insurance companies, the tool & die shop her father worked for had excellent coverage. Each time company had to change, she wasn’t the only dependant who could easily cost $1 million a year; i had to learn new forms, new copays, new people to fight with for her to get her O2 and treatments. Thankfully, at that time there was a federal program that picked up co pay and supplies that insurance wouldn’t cover; people don’t choose to have a genetic based disease. From what I understand she was five before the doctors figured out what was wrong with her. What got to me more than anything was looking over the bills, if a doctor poked head it to say “hi” to her even though wasn’t involved in treatment the bill would show that he had charged for a visit.
Mnemosyne
@dnfree:
Do you mind if I ask what state you’re in? I know that high-cost, low-population states like Colorado were having serious issues getting costs under control even with subsidies and Medicaid Expansion.
Ruckus
@David Anderson:
Yes we might lose a John Lewis, we also might gain a few more in his vein.
Do you have a better way of protecting the country against too much power in the hands of a few politicians from maybe thousands of miles away controlling your future? That you didn’t and would never vote for. When it was 13 states in the relatively same geographic area, with only a few people who could afford to run, with most people in agrarian life the idea of term limits or some other mechanism to limit the power was not really necessary. We don’t live in that world any more. Farmers make up what less than 5% of the population and mostly are very large corps? The majority of us live in very urban areas and do far different work than was envisioned over 200 yrs ago. The concept of land mass owned/controlled as the critical determinate of power is no longer valid, if it ever was. People in the major cities are not being represented like rural states because of limits placed upon the size of congress.
All of that said, do you think our federal government should remain unchanged or what steps do you think might bring a better, more uniform structure to our government, possibly giving us the government that Lincoln talked about, “A government of the people, by the people, for the people”?
Ohio Mom
Term limits are a terrible idea and the City of Cincinnati is a case in point. We had a pretty decent city council until out of nowhere, Term Limits.
There really isn’t that deep a bench, anywhere. Since the core group of seasoned and reasonable council members hit their time limit, the replacements have been one motley crew after another.
No one gets to stay around long enough to mature into their role, or mentor anyone else. The big business guys know if they don’t like this Council, just wait a few years, there will be a new group to push around. And they do.
Also, I noticed term-limit fever seemed to limit itself to the Democratic city proper. There was never any push to term limit any suburban city and village’s governing body. Funny coincidence, they are mostly in Republican hands.
Sab
@West of the Rockies (been a while): Ohio has term limits, and that has pretty much destroyed the state. The Republicans are all scrambling for their next job, and lining up the necessary benefactors to finance it. The Democrats all serve for a couple of terms then disappear back into the private sector. The only people around for long with any institutional memory are the lobbyists.
Ruckus
@Brachiator:
And CA term limits are way too short. For them to work they have to allow for institutional learning and have a path up the food chain, which every human organization has, and yet still control the inability of people to have any effective say in who controls their government. Which is what happens when a person gets entrenched in a political office. I can name a number of people it would be horrible to lose their expertise and yes wisdom, but the corollary is also true, there are any number of people one can name whose no longer being in a position of power would help everyone. Immensely.
And yes vigilance is absolutely necessary because power can corrupt, absolutely.
Karen
I still haven’t decided if term limits are good or bad; I remember when one WI representative was replaced he said that the new guy wouldn’t know how to work the system to bring money into the state. I know that big corporations like the idea since new people are cheaper to buy that long timers, at this point those who have been in office for years don’t care about the people but money they are putting in their pockets and following party line.
I will never forget the elected official that went on local news station that said that now that he was in office he didn’t want to hear from constituents he was going to follow party line and do what the big money said. He actually bragged about “screwing over” the people in his district.
But her emails!!!
@Ruckus:
Term limits enhance the power of the wealthy to control government. In supporting term limits you’re actually aligning yourself with billionaires and multimillionaires like the Devos family that back the sort of propaganda that has made term limit legislation popular. The reason for this is simple. If politicians are term limited, they have less time to develop their own base, funding, policy shop, etc. That leaves them more dependent on their respective parties and on the infrastructure set up by the wealthy donor class. It also dilutes the power of your vote. Voters vote for the first election and then maybe once more for a single reelection. There’s no real reason to look out for the interest of voters, because regardless of how you perform your voters, you’re going to be leaving office anyway. If you look out for the donor class, they’ll make sure when you get term limited, you get a nice, cushy job at a think tank.
But don’t take my word for it. Many states have implement legislative term limits. Take a look at them and tell me whether you think the wealthy have less control their than in other places.
Ruckus
@dnfree:
What would they have been paying now if the ACA hadn’t been instituted? What sort of insurance would they have?
Understand that their cost is way too high but I just went to the CA insurance site and a family of 4 a platinum 90% HMO plan with Kaiser is 1140/month. CA is not 1/2 the cost of medical than CO. Now the income I put in does get this person a $196 subsidy but let’s take that out, the cost is $1336. Something sounds fishy at $2500/month.
Laura
@David Anderson: another thing about term limits, it denies the voter the choice to re-elect competent legislators who do a good job and are responsive to their constituency.
Ruckus
@But her emails!!!:
The devil is always in the details.
How long are those term limits? Mostly they are way too short, which is exactly what we have in CA. And at that, as I said above and have said many times before, is no better than no term limits and in many ways worse. Too short gets us exactly what you say, little to no institutional learning, good people out before they can do good, it’s throwing out the baby with the bath water. I asked David what else can we do and as usual I get the same answer and that is term limits are no good.
So what else ya got? Keep going like we are, or maybe try to come up with something better to reflect the changes that have happened over the last 240 yrs? Where we’ve arrived at really isn’t working all that good for the majority or the minorities, what’s your idea? How do we make things better?
Ruckus
@Laura:
This to me is the biggest drawback to term limits. But we have a structure that allows us to be in state government, then federal government. If we had reasonable term limits a person could spend their entire adult life in elected government with a career much longer than most working people. You could spend over 50 yrs as an elected official in state and federal government under my plan. How long do you plan to work at your career? I started learning mine at 13, I have 55 yrs experience and I’m really, really thinking of retirement. If I had started at 18, I’d of hit that 50 yrs. Let’s say you get elected at 25 and spent 50 yrs in elected office, you are 75 or maybe more. I’m not that far away from 75 and I’m thinking that if I was 30, I’d be hard pressed to want a 75 yr old making decisions for me, unless that is an exceptional 75 yr old. How many of us not in politics are doing the same job at 65 or 70 that we were at 20 or 25?
Ruckus
@Ohio Mom:
On the flip side of this I was raised and lived in a small bedroom community in southern CA that had the same council members for decades. They would allow no growth at all. Example we had a hardware store, the owners aged and the kids wanted no part of it so they closed their 2 story hardware store. The city council had a lot of different people that wanted to purchase and open different stores. No it was a hardware store and it will remain a hardware store or nothing. Not so bad, until the same situation repeated itself a number of times and the town started to look boarded up and dead, which it was. Finally a couple of other people got elected and now the town is much stronger, new businesses came in the downtown area has been revitalized and it works. Progress marches on, too little control or too much and it marches over.
Lizzy L
I’m retired now, but I was self-employed for most of my working life, and I have always paid for my own medical insurance. The year before I went on Medicare, while I was still working two jobs, my Kaiser insurance premium was just under $800 per month, which was about a third of my income, and more than I pay for my mortgage. The year I turned 65 I switched to the Kaiser Medicare Advantage program. My premium dropped to $104/month for Kaiser. I pay about $100/month for Medicare itself. I cannot tell you what a difference that has made in my living comfort.
Karen
If we have term limits then the benefits should match those in “real world” none of this insurance for life or anything else. If it take your local community 10 years to earn 2 weeks vacation, the same should apply. If your insurance runs out after 30 days you are going to think long and hard about those who voted for you having no insurance.
I know people that wouldn’t change jobs for fear of losing their insurance and having something small claimed as pre existing condition. I don’t care what you say, people aren’t free, there are no good choices for many and the rich in power don’t care.
Small town, Maine; people still support, have flags and signs out that support T&P; they are ignoring that mill is still running but with less people , they are ignoring all the empty homes, apartment buildings and worse the pollution appears to have gone up since the film on my SUV has gotten heavier and thicker in three weeks. What I do know is that some days it is hard to breathe. so we can thank the ‘president” for lifing restrictions that keep businesses down
Calming Influence
Term limits happen every 2 or 6 (or 4) years. History has shown even the most entrenched politician can be voted out.