As many as 3.5 million people over the last few years have gotten their health insurance through COBRA, the program that allows people to stay on their or their spouses employer's policy after loss of a job, or the death of the spouse. It's helped millions of people, but not every laid-off worker or widow because it's expensive. Enrollees have to pay the full cost of premiums—both their and their employer's contributions. One 2009
study found that less than 10 percent of newly unemployed people could actually afford it. It also ends—18 months after a lost job and 36 months after divorce or widowhood.
Enter Obamacare, and a brand-new freedom for COBRA enrollees. Jonathon Cohn talked with one, Donielle Scherff, a 37 year old with lupus, who just started her own business, is better able to manage her disease, and is paying less for insurance every month. A lot less.
The obvious solution was to work on her own, as an independent contractor: “Being able to set my own schedule, to work freelance, makes me not just happy but healthy,” she says. But until Obamacare came along, the only way for her to get reasonably priced coverage was through COBRA. Even then, it was expensive—about $550 a month—and she'd have to shop for new coverage after 18 months. (Scherff provided me with documentation to verify these details, as well as additional sources to corroborate the broad contours of her story.)
Now, thanks to the Affordable Care Act, she’s found insurance through the online marketplace for Virginia. After waiting through the initial technological problems, she shopped and settled on a gold plan, which means it’s among the more generous options available. For this plan, from Kaiser Permanente, she pays $344 a month. If you do the math, you'll see that's roughly $200 less than the monthly COBRA premiums.
Cohn is very clear that there are trade-offs for Scherff, which she perfectly understands as well, but is happy with nonetheless. It's possible that she'll end up paying more out-of-pocket with Kaiser if her illness progresses to the point that she needs a lot of care, even more than she's saving in lower premiums. But her prescription costs are much lower and she's saving money now, so she finds that possibility acceptable. She's also comforted in knowing that, if she does get sicker, she now has comprehensive insurance and it's much more secure under Obamacare than before.
"If my disease gets worse, it could be the difference between being disabled and being able to work," she says. "It opens up lots of possibilities to be productive and contributing to society."
That's freedom. She's striking out on her own, starting her own business—which used to be the Republican version of the American dream, before Obamacare made it possible.