COVERAGE: 51, Healthy, Wealthy and Having Trouble Getting Insured ... Again

If voters had been feeling a little differently a year ago, Doug Holtz-Eakin (former Congressional Budget Office director and chief economic policy advisor to Senator McCain's 2008 presidential campaign) would be spearheading the McCain health care team.

And, if voters had been feeling differently a year ago, Holtz-Eakin would still have employer-sponsored health coverage.

But instead of a position with the McCain Administration, he is unemployed -- and the clock is ticking on his current health coverage. He will soon join the scores of Americans who are having difficulty obtaining affordable, comprehensive health insurance. "I worry about where I go next in the way many Americans do," he told the Washington Post.

Holtz-Eakin walked away from the 2008 presidential campaign without a job and therefore without employer-based health care. Since then, he has been able to keep the private health insurance plan he had during the campaign through COBRA (the acronym for the Consolidated Omnibus Budget Reconciliation Act, a 1986 federal law that allows individuals to temporarily extend group health coverage to people whose health benefits otherwise would be terminated). 

Holtz-Eakin currently pays about $1000 each month for his COBRA coverage. (As the U.S. Department of Labor website explains, "Under COBRA, as a former employee no longer receiving benefits, you will usually pay the entire premium amount, that is, the portion of the premium that you paid as an active employee and the amount of the contribution made by your employer. In addition, there may be a two percent administrative fee.") Since COBRA generally allows people to keep their plan up to 18 months after their employment ends, his coverage will expire shortly. (It's worth noting that the American Recovery and Reinvestment Tax Act of 2009 provides a 65 percent government subsidy to certain employees who are involuntarily terminated between September 1, 2008 and December 31, 2009 -- though this is not Doug’s situation).

Unfortunately, Holtz-Eakin has a pre-existing condition. In 1990, he received a right renal auto-transplant following an accident. As a result, he is virtually uninsurable in the individual insurance market. Either premiums will be really high or coverage may be denied altogether because of his health history. This will present a challenge for Holtz-Eakin when his COBRA coverage runs out.  He explains that his surgeon "got rid of the artery, moved my kidney and rebuilt me for the 21st century. If you look at my file, any insurance company would go... ‘Hmmm.'"

As Holtz-Eakin points out, like John Hewko whose story was featured in the Washington Post a couple weeks ago, he is lucky to be financially secure in the face of this challenge.  Nevertheless, his story serves as a reminder that there are millions of other hard-working, self-employed or laid-off Americans in similar situations, many of whom cannot afford to pay for COBRA.  And when COBRA ends, many of these same Americans are unable to access insurance altogether or afford the very high premiums that come with a pre-existing condition.   

We can debate the best way to solve our health system's shortcomings (and we're sure Holtz-Eakin would offer his opinions), but stories like this illustrate that failing to fix our health care system comes with high and rising social and economic costs.