As of today— April 10 — due to the outbreak of COVID-19, nearly 350,000 Minnesotans have applied for unemployment benefits. That is already more than the total number of applicants in all of 2019. Nationally, 16.6 million Americans have applied for unemployment benefits in the past three weeks. In the wake of a global pandemic, millions of American workers are jobless. Economic uncertainty abounds, and there is no telling how soon these workers will find themselves employed and financially stabilized.
With a national healthcare system that links employment and health insurance coverage, that means thousands of Minnesota families and millions of American families are also losing their health insurance coverage.
Those who are newly unemployed and losing their health insurance have the following choices:
1) Remain uninsured during a global pandemic that could require hospitalization;
2) Pay a sky-high COBRA premium to retain their employer-based coverage (if they were lucky enough to have that); or
3) Look to MNsure or their own particular state’s insurance exchange to find health insurance for their family.
Options two and three very well might include a hefty monthly premium AND a deductible of $3,000 to $8,000.
Thankfully, Governor Tim Walz worked out a deal so most Minnesotans covered by nonprofit insurance plans will not face out-of-pocket costs if they or their family members need testing or treatment for COVID-19.
But what about everyone else? What about those who are covered by corporate plans the state doesn’t have the power to negotiate with? What about those who are uninsured? What about those who are newly unemployed and face a health crisis unrelated to COVID-19?
It turns out that many Americans don’t even have $400 in the bank to cover an emergency expense, let alone the thousands of dollars that could be needed to cover an unexpected health crisis.
We applaud Governor Walz for finding a solution that will help thousands covered by state nonprofit insurance plans. We applaud the administration for re-opening the MNsure marketplace to make buying health insurance available to the uninsured.
But this crisis uncovers the injustice within our current health insurance system.
This crisis makes it clear that a strong stock market means very little to most working people, who still can’t afford to be sick, to miss work, or to access life-saving care when it is essential.
This crisis makes it clear that healthcare is a human right that should be consistent and stable, regardless of one’s employer or employment status.
Linking the essential need for health insurance and healthcare to the unpredictable and regularly changing prospect of fulltime employment never made any sense. Now, more than ever, the senselessness of having such a linkage has been exposed.
Thankfully, there are alternatives that could boost public health, create greater financial security, and help protect our families and our nation during a time of crisis.
In Minnesota, state leaders opted to expand Medicaid coverage years ago when the Affordable Care Act went into effect. Some newly unemployed individuals and their children may find they now qualify for Medicaid or Medical Assistance. Others may find that they and their families qualify for MinnesotaCare, a Minnesota-based public health insurance program that caps eligibility at 200% of the poverty line. They are the lucky ones who find themselves on public health insurance programs that truly make healthcare affordable, with affordable monthly premiums and minimal out-of-pocket costs.
The only unfortunate piece of this story is that not all newly unemployed Minnesotans will be eligible for these great public insurance programs that make health insurance TRULY affordable.
But it doesn’t have to be this way.
All of us could have truly affordable health insurance coverage that no employer would have the power to change or take away from us—through a change in company policy or an unexpected layoff.
All of us could have health insurance coverage that a change in employment status would not affect, that would alleviate the stress of putting food on the table, caring for our families, AND trying to figure out how to pay the bills if someone in our family becomes sick and requires lifesaving treatment.
Not everyone is protected by the Minnesota deal to eliminate out-of-pocket costs related to COVID-19. Nobody is immune to the devastation of a healthcare crisis unrelated to COVID-19, but this deal shows us what is possible.
The answer to this national conundrum is a single-payer health insurance program like Medicare for All, or Improved Medicare for All, or Medicaid for All: an expansion of existing public health insurance programs that cover everyone with sliding scale, income-based premiums paid like taxes and little to no out-of-pocket costs at the point of service.
In Minnesota, a state-level solution is creating a MinnesotaCare buy-in option that is open to farmers and other small businesses, artists, sole proprietors, and the unemployed; ideally, this buy-in would be available to anyone without other access to TRULY affordable health INSURANCE and healthCARE, with sliding scale premiums that increase incrementally with income and require little to no costs at the point of service.
These programs are possible. We know they are possible because they already exist in Minnesota and the U.S. in general for those of us with low enough incomes. The Governor reached a deal to ensure that this kind of care without out-of-pocket costs is possible for many Minnesotans who may need treatment for COVID-19.
Now it’s time to expand these programs to everyone, to eliminate profit-making within healthcare systems, and to ensure that all of us are covered, no matter our employment status, no matter our healthcare crisis.
Yes, these programs require higher taxes from major corporations and those in the very upper income brackets. And these programs require some level of individual payment in the form of taxes for most people living above the poverty line.
But in return we get improved public health, the safety net of knowing theses great programs are available for all of us—no matter our individual or family circumstances. We get the freedom to retire early or start a small business, knowing that healthcare coverage is available outside of fulltime employment. As it should be.
Please note that this is not a call for government-run hospitals. This is NOT a call for government-run healthCARE.
This is a call for widespread public health INSURANCE programs that ensure nobody is left jobless and without affordable, usable health insurance, not now (during a global pandemic), not ever.
At a time when an apparently strong economy has been usurped by widespread economic uncertainty, tanking stock markets, and record unemployment, let us have the courage to ask big questions and demand big solutions.
Your employer should not have the power to choose your health insurance. Healthcare is a human right that is irrevocable, no matter your employment status. We have the means to ensure that all of us get the lifesaving care we need, when we need it, without bankrupting families experiencing an employment or healthcare crisis.
We have the means.
Now let this time of international crisis create in us the WILL to DEMAND more humane healthcare systems, in Minnesota and across the U.S.
Jennifer Jacquot-DeVries lives in Brainerd, Minn., and is a member of the Land Stewardship Project’s Healthcare Organizing Committee, which is striving to build a more affordable healthcare system for all Minnesotans.