Yes, people do lose their insurance constantly when they switch jobs...and then immediately sign onto their new plan. Is the argument that switching insurance plans is stressful? What's stressful is remaining uncovered. Switching plans is hardly comparable to the transition to a Medicare-for-all program.
Nope. Employer-provided insurance plans often have blackout dates.
If you quit your job on June 2, and start your new job on June 3, your new job's health insurance might not actually take effect for up to 30, 60, or even 90 days after your start date.
To cover that gap period, you either have to switch to a new plan with your old employer (commonly called COBRA) at ridiculous high rates nobody can afford, or you have to get temporary blackout insurance coverage (which cover nothing at all, and are almost identical to having no insurance).
In America, to switch jobs once, requires three concurrent interactions with three different health insurance plans, simultaneously. (Your old employer plan, your intermediate temporary plan/COBRA, and your new employer's plan). For obvious reasons, this is incredibly error prone, risky, and fraught with stress.
> Is the argument that switching insurance plans is stressful?
Yes! Literally every single interaction with every single health insurance provider is painful and stressful and complicated and intentionally obfuscated, for absolutely no valid reason whatsoever.
As I painfully found out, transitioning between jobs also requires competent HR people on both ends. Our insurance was accidentally terminated a week early so our claim was denied and we got a massive bill. Not only do you have to then deal with the insurance company but you have to deal with your previous employer to fix the situation.
This doesn’t even cover pre-existing conditions. So, if you are on medication for high blood pressure, or have diabetes, or are just one of the 55 percent of Americans who take prescription drugs... you are out of luck.
That these plans are even legal is a monumental failure of the American system.
> Yes, people do lose their insurance constantly when they switch jobs...and then immediately sign onto their new plan.
Lets say you payed for insurance, but were healthy for the 90s. So ~10-years of paying insurance. Around 2005, you are diagnosed with Diabetes, so your insurance pays for your care.
Around 2007, the recession happens and you lose your job. You immediately find a new job, but you need to get new insurance. Diabetes is now a "pre-existing condition", so your insurance no longer covers your condition.
Its important to recognize that changing health-plans is a regular event, that shouldn't punish people with chronic conditions. Diabetes is lifelong, once you get it, you live with it for the rest of your life. Insurance companies don't want to pay for that kind of issue. With all talk about "Repeal and Replace", its important to recognize the tradeoff.
As long as "pre-existing conditions" are banned in the USA, I don't think its a big deal to lose employer sponsored health care (at least, compared to pre-Obamacare). We should build a world where it is easy to lose (and regain) health coverage... compared to the pre-Obamacare world where it was a big risk to lose coverage. Hopefully laws of the future make it easier to switch health care plans without problems.
If you find a new job and you’re eligible under group insurance, the insurance company can’t deny a claim under pre-existing conditions. This was true before the ACA. What the ACA changed was that insurance companies couldn’t exclude treatment based on preexisting conditions if you go on the open market.
Pre-ACA group plans could deny preexisting conditions for a time period equal to the time that you were uninsured.
When I switched job I would get a letter from previous insurance company stating the dates that I was insured. Once I actually had to provide that to the new company.
That’s been ameliorated somewhat by ACA and is the only reason I think it’s an improvement even though my premiums have gone up. There’s all sorts of pre-existing conditions, and healthcare with the threat of retroactive recision if they feel your application was incomplete ought to feel insecure to just about anyone.
I don't mean that it's affordable, I just mean that the reason isn't a pre-existing condition exclusion. For insurance for myself I'm paying $484.71 a month and there's a $5850 deductible, after which it probably only covers some percentage of it, until a maximum out of pocket is reached (this information isn't viewable in my account online and is probably in some mail that I've thrown out). Certainly not affordable.
A pre-existing condition exclusion means that you're on your own for expenses arising from your pre-existing condition, or if you didn't report it when you applied for your health insurance, that you could have your health insurance retroactively cancelled, and have to pay back any money you received. It's really bad, but since some healthcare expenses seem to have more than tripled in the last 10 years, it's often worse today. I'd much rather pay 100% of $800 than 50% of $3000.
Insurance is expensive in this country because medical care is expensive.
Medical care is expensive for a variety of reasons: nurse shortage, high-cost of training doctors, poor market conditions (opaque pricing that almost no layperson understands), cultural emphasis on fighting to the end rather than dying with dignity.
The cultural part probably won't change, we just have to accept that USA's culture (aka: "Full Code") is going to naturally result in more expensive health care. Its far more expensive to try to live than to accept death. Maybe someone out there will fight the cultural battle, but I don't see any political advantage in doing so.
Other issues can be worked on. Doctors aren't necessary for all care: nurses are sufficient for most cases. Lowering the cost of becoming a doctor likely would help too: if doctors had less medical bills, they might charge less for their services. (They HAVE to charge a lot to pay off those $200k+ to $300k+ student loans).
Medicine / Drugs is getting political... because changes to drug laws necessarily becomes a patent dispute. Should we allow drugs from India to become FDA-tested and imported? Or should we keep them banned for patent-law issues?
There's research issues: FDA is purely a placebo test. There's almost no comparative research going on at the federal level (Obamacare started up a comparative research group, but that group needs more funding and probably should also research on the PRICE of medical solutions. For whatever reason, research of prices is illegal). FDA is a very, very rigorous placebo test, but that's all it is. If a new drug comes out that's better than a placebo (but worse than standard treatment), it will pass the FDA. This means that doctors still have to research which drugs are most effective for their patients on their own.
Doctors can't trust insurance companies when they pay for research: insurance companies are looking for the cheapest solution. Drug companies are obviously biased, and may not conduct fair comparative trials. And unfortunately, those are the two major groups which sponsors research in the USA.
The problem with covering pre-existing conditions at all times is that you need to make insurance mandatory, due to the adver selection problem.
If insurance is optional, then only people that know they are sick or will get sick will dominate the insurance, making it more expensive, and pushing the healthy-low risk out.
Its a well known economics problem that has no silver bullet.
What is crazy to me is that insurance is involved in paying primary care doctors. That is a terrible application of health insurance, and have full faith on high deductible plans bringing sanity back into this.
If you switch to another insurance provider, you might have to change doctors, pharmacies and other service providers, because your previous service provider is no longer in-network or too costly.
Also your coverage may completely change for better or worse. The worst case scenario is just as disastrous as losing insurance entirely.
This is particularly bad for people with chronic/ongoing medical needs.
>Yes, people do lose their insurance constantly when they switch jobs...and then immediately sign onto their new plan.
Unless they lose their jobs. Or change to a job that doesn't offer coverage/start a new business. Or have their hours cut to be <40 hrs/wk and are no longer eligible. . .
>Switching plans is hardly comparable to the transition to a Medicare-for-all program.
Why? It would be a one-time switch. Switching costs would be exactly the same as the switching costs you pay every time you change jobs, except you only pay it one time in your life and you don't have to shop around in some silly healthcare exchange or open enrollment process where you get to weigh which absurdly high premium you want to pay despite deductibles being so high that barely any of your routine health costs will be compensated.
And then there is the joy of making sure all your care providers are covered by your new plan. AND hoping your providers don't drop your plan because of insurance company negotiations.
It’s not just when you change jobs. My wife handles large employer groups and the insurance companies ask for a 15% rate increase every year so the employers have to threaten to switch every year to negotiate down then actually switch every other year. It’s a wasteful, useless game. Even if you stay at same employer, your insurer and networks will regularly change.
They lose their insurance for other reasons, too. Their employer changes plans; they get dropped from full time to part time; they lose their job and don't immediately get another.
And switching insurance plans at almost any time can be very costly, even if you go straight to a new one, as all your deductibles and out-of-pocket limits get reset. And then you have to hit them again when the plan year starts again, almost certainly sooner than a year later.
My employer switched health insurers 3 years in a row. First because we became a new company (understandable), second because they thought they could get a better deal at another place (okay...), and thirdly reverting the 2nd change except some of the numbers and coverage is different now.
I really am considering leaving if they switch a 4th time.
> Switching plans is hardly comparable to the transition to a Medicare-for-all program
The big stressor is having to pay two deductibles in one year. That said, from an individual perspective I don't see what would be different. Before you had an (Aetna|Cigna|BCBS|UHC) card, now you have a M4A card.
>Is the argument that switching insurance plans is stressful?
I think it’s clear the article is promoting universal coverage, and simply highlight how ridiculous it is that healthcare is a benefit of employment by highlighting nearly 1/3 of employment based plans are discontinued within 12 months.
I’m not sure how you can conclude switching private insurance plans is hardly comparable to a transition to Medicare-for-all, when millions of people make the jump from private insurance to Medicare every year and you don’t hear much complaining from that group. Not to mention a 1 time transition compared to nearly 33% of the workforce going through this annually.
> Is the argument that switching insurance plans is stressful?
It absolutely is stressful, because every single time you have to carefuly inspect the documentation to figure out what conditions and care (if any) you're "allowed" to have without going bankrupt.
I don't understand why you're downvoted. It's an important observation.
In my case, my employer was bought and sold 3 times. All three cases involved a sudden and abrupt termination of my insurance.
It was "okay" when I was single, but once I carried my wife, and then my entire family, it became a huge problem.
Throughout my tenure at my job, I had major surgery and two children. Sudden insurance changes immediately before or during any of those events would be a huge problem. (Fortunately, the timing worked out.)
Europe also has a broader fix for this, called Transfer of Undertakings rules, the UK version is "TUPE" the "Transfer of Undertakings (Protection of Employment) Regulations".
The broad overview of TUPE is that employees whose actual job doesn't change shouldn't have to put up with any negative consequences at all for the fact that at some higher level their employer changed. e.g. the office building switches from Ace Cleaning Corp. to Best Cleaning Limited, but it's still Jenny and Achmed actually doing the cleaning, just in blue overalls instead of yellow now. It makes no sense to be allowed to tell Jenny now she's only getting minimum wage because Best Cleaning Limited doesn't pay as much as Ace Cleaning Corp, she's doing the same job so she should continue to get the same pay.
But I don't mean just obvious stuff like they can't cut your pay, it's everything - your seniority is preserved, shift priorities, rules for how much paid leave you get, or how pensions are paid - if it was part of the job, then it moves with the job. If employment-based health insurance was a big thing here, that would undoubtedly be covered.
With the current love for High deductible plans, it can get much riskier. I just walked away from a plan where I had paid the full Out of pocket max for the year (around $7k), in January. That hurt, but the other offer was good enough.
None of that money translates to the new plan, I'm back to paying deductibles for everything.
My wife recently worked for a startup and had them change the company policy to start benefits on day 1 simply by asking. No one really knew why the benefits started after N days and no one cared enough to change it previously.
One time I switched jobs the company I left was so small (I think ~ 15 to 18 people) it turned out that COBRA wasn't available and new job benefits didn't kick in for 90 days. This was between when the ACA was passed and took effect so getting private insurance for the gap was scary. (Going without coverage was not an option, I have serious medical history.)
How about having to switch doctors, or having to go a couple weeks without an insurance card, but hey, you still have insurance and you can pay up front and get reimbursed later? Big fucking deal, right?
