Three out of five adults who lost a job with health benefits in the past 2 years became uninsured and many of those people and their families went without basic medical care, according to survey aimed at assessing the impact of the recession.
Conducted by the Commonwealth Foundation, the analysis found that 72% of the 43 million adults who lost jobs during 2008-2010 have failed to fill a prescription or they skipped a recommended test, treatment, or follow-up. The same group also said that, due to high costs, they did not go see a doctor when they had a medical issue.
Many reported that medical bills forced them to spend all their savings (32%), go without paying for necessities like food, heat, or rent (27%), take on credit card debt (14%), or take out a loan or home mortgage (9%). The findings were based on the Commonwealth Fund 2010 Biennial Health Insurance Survey of 4,005 adults aged 19-64 years.
Dr. Yul Ejnes, a general internist at Coastal Medical in Cranston, R.I., said that the findings are consistent with what he has witnessed in own practice. Over the past few years, more of his patients have cancelled appointments or requested generic medications after being laid off. Dr. Ejnes said he often reduces his fees and sometimes even waives fees for regular patients who lose their jobs. While he has been able to adjust his own fees for those who need it, Dr. Ejnes noted that not all practices have that option. And, even if his patients do get in to see him, often they are unable to afford high-cost items such as MRIs or medical procedures.
"Depending on how many [uninsured] patients there are and what the practice demographics are, it can cause some strains on [a] practice ... it’s a burden I’ve been able to absorb," Dr. Ejnes added in an interview.
Although the Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows laid-off workers to keep their coverage for up to 18 months, few people enrolled during 2008-2010 because of high premium costs. "Once you are unemployed and uninsured, it’s nearly impossible to afford COBRA or buy an individual policy," noted Sara R. Collins, Ph.D., vice president for Affordable Health Insurance at the Commonwealth Fund and coauthor of the report. She added that provisions of the Affordable Care Act will transform access to care.
"When it is fully implemented in 2014, the Affordable Care Act will usher in a new era for the unemployed, who will have a variety of options for comprehensive and affordable health insurance," Dr. Collins said. Until then, the report recommended extending jobless benefits and reestablishing COBRA subsidies to help uninsured Americans keep their coverage.
The Commonwealth Fund is a nonpartisan foundation supporting research on health policy.