By Jessica Schorr Saxe, M.D.
The Charlotte Post, May 27, 2020
Rapidly and predictably following the onset of the pandemic, many Americans are victims of an epidemic of uninsurance, which will also predictably lead to suffering and death.
This loss of insurance is a uniquely American epidemic, not a pandemic. While millions of Americans risk losing health insurance if they lose their jobs, citizens of other developed countries, where insurance is not linked to jobs, do not.
Nearly 50 million people in families where someone lost a job in March or April will lose employer-sponsored insurance. While some will be able to retain coverage through another family member, almost 27 million will be uninsured. In North Carolina, at least half a million people are expected to lose their insurance. While some will be eligible for Medicaid or Affordable Care Act policy subsidies, nearly 200,000 will remain uninsured and join the half million already in the coverage gap.
And, just as the pandemic itself has disproportionately affected African Americans and Latinos with higher rates of infection and death, so, too, has the resulting unemployment.
Even those eligible for other insurance will find the transition disruptive. Perhaps you have just lost your job or can imagine doing so. You already have stresses of lost income, uncertainty, and waits that feel interminable to get unemployment insurance. In addition, you will need to sort out what health insurance you are eligible for, jump bureaucratic hurdles to apply, and then, if you are successful, navigate different networks and new providers.
You may experience interruptions in needed care or medications. And even if you are eligible, you may be unable to afford premiums when you have no income and may still find yourself uninsured.
The pandemic has unmasked the abject failure of a system based on employer-sponsored insurance, which, like a fair-weather friend, vanishes when we need it most.
Measures taken so far are woefully inadequate. While both the Families First Coronavirus Response Act and the CARES Act covered some testing, they did not cover all. In the words of the Kaiser Family Foundation, āCOVID Tests Are Free, Except When Theyāre Not.ā Treatment has not been covered for COVID patients, let alone those unemployed who are suffering from something else.
HR 6906 and S 3790, introduced to Congress on May 15, is the best short-term solution to address the uninsurance epidemic. It would provide comprehensive coverage without co-pays for both the uninsured through improved Medicare and for the insured by subsidizing their insurance coverage. Other features include banning surprise billing, controlling prescription drug prices, and forbidding insurance companies from decreasing coverage.
This bill would give Americans the best chance of protecting their health at this difficult time. In addition to covering diagnosis and treatment of coronavirus, thus helping to prevent spread to the rest of us, it would also cover management of diabetes, heart disease, and other critical health conditions, as well as preventive care.
A recent survey of voters showed that about three out of four, including over half of Republicans, support this approach. In the long run, we need a healthcare system that serves us all.
Dr. Jessica Schorr Saxe is a retired family physician in Charlotte and chair of Health Care JusticeāNC.