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Opinion: Looking beyond COBRA for health coverage in the days of the coronavirus

The numbers are impossible to get your head around. Hundreds of thousands of American deaths to COVID-19 projected by the end of April. More than nine million new unemployment claims in two weeks.

It’s probably not healthy, but when I read these figures, I go through a mental exercise to try to grasp the impact on a human scale. The death of a single friend or family member goes too deep. The loss is permanent and beyond calculation. I can’t even go there.

Luke Clarke

I can get closer to something I understand with the loss of a job because 11 years ago, I lost mine. I reflect on it nearly every time I read the weekly total of the newly unemployed. The loss of income, insurance, professional identity and sense of purpose – just take that and multiply it by nine million.

But 11 years ago, I had cushions that I know aren’t there for thousands of Coloradans who woke up today confronting life without a job. My wife was employed, so our income was about half what we were spending – re-budgeting was hard, but doable.

Just as importantly, I could ignore the COBRA letter that offered me the chance to keep our health insurance without my employer paying most of the cost. The more than $900 monthly premium would consume more than half of my unemployment benefit.

We were able to get covered through my wife’s job for a couple of hundred dollars a month. Otherwise, it would have been health insurance or the mortgage, but not both.

How many of the 61,000 Colorado households filing for unemployment in a single week have the same cushions that carried my family through the months of the Great Recession? Not enough.

And my choices 11 years ago were not colored by a global pandemic like the one we have today. It has to be the worst time ever to be going without health insurance. I don’t have the arithmetic on that.

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There are, however, some resources that have come into existence in the past 11 years. 

Colorado created a health insurance marketplace, ConnectforHealthco.com, where households can get affordable comprehensive health insurance. (Full disclosure: I worked on the staff at Connect for Health Colorado for four years and continue to serve as a consultant to the communications team there.).

Colorado also expanded Medicaid coverage beyond children and pregnant women. Now an individual making as much as $16,980 a year, or a family of four living on as much as $34,848 a year can get Medicaid (higher for women and children). It’s now called Health First Colorado, and you can find it at healthfirstcolorado.com.

If you go through Connect for Health Colorado, you can get financial help in the form of a tax credit to lower your monthly premium, if your income falls under the federal guidelines. An individual making up to $49,960 a year can qualify for that help, as would a household of four with an income up to $103,000 a year.

For illustration purposes, I looked up what would be available to Colorado residents now at the income level and ages for my wife and me 11 years ago. The plans available have sticker prices around $1,000 a month but the $719 a month tax credit we would get with our 2009 income ($60,000 a year) puts the monthly premium on several plans under $300 a month.

Comparing the cost and benefits under the group plan I would have got then with COBRA vs. an individual plan today is  rough at best, not apples to apples, more apples to oranges.

But I am certain that many Coloradans can find a much more cost-effective alternative to protect them from medical bankruptcy than what is offered in the COBRA letters they are receiving. 

Unlike Healthfirst Colorado, which can take enrollments any time, enrollment in private health insurance offered through Connect for Health Colorado is subject to certain periods. In response to the novel coronavirus outbreak, Connect for Health Colorado opened a special enrollment period, which has been extended to April 30.

Luke Clarke is a communications consultant specializing in health care policy (@GLukeClarke, luke@clear.bz)


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