Morrison Memo: Debate over insurance reform is healthy

The contentious debate over health insurance isn’t unique to Congress, it’s occurring on a daily basis all across the nation and in Arizona:

To the worker with no health-care benefits: “Should I pay the light bill or go the doctor’s to check on this nagging cough?”

To the unemployed worker: “Should I continue to pay COBRA or apply that dollar amount to my late house payment?”

To the union worker: “Should I consider striking or just be happy to have a job with benefits and accept the fact I have to pay more for my health insurance?”

Too many Americans are living without health insurance.

How many? Estimates vary, but the Census Bureau’s annual report released in September puts the figure at 46.3 million Americans in 2008. The actual number is likely higher since it does not include the hundreds of thousands of layoffs this year that resulted in loss of employer-provided insurance.

Arizona has one of the highest levels of residents without health insurance – almost 20%, or one in five residents, as noted in the 2009 report, Truth and Consequences: Gambling, Shifting and Hoping in Arizona Health Care.

By and large it’s not the very poor doing without insurance, since many are eligible for Arizona Health Care Cost Containment System (AHCCCS) coverage, Arizona’s version of Medicaid. No, it’s your working-class neighbor – if not yourself – who’s living without coverage. Eight out of 10 Arizonans without insurance are in households where one or more members works at least part time, according to the Truth and Consequences report, prepared by Morrison Institute for Public Policy. And as more full-time employees get laid off, along with the disappearance of dependable paychecks so go their employer-provided health care coverage.

The high cost of COBRA (Consolidated Omnibus Budget Reconciliation Act) prevents many unemployed Arizonans from purchasing the federal government’s stop-gap insurance program, which was never intended to provide long-term coverage.

In Arizona, where average unemployment insurance benefits are $937 a month, the average family COBRA premium is $1,084 – or 116% of UI income, according to a 2009 study by Families USA, a national organization for health care consumers.

In response to the worst recession of our time, the federal stimulus package reduces the COBRA premium for recently unemployed workers so they pay just 35 percent of the usual amount – but only for up to 9 months, at which time COBRA can again charge 102 percent of the premium the employee and employer collectively were playing for insurance.

With their inherent and colossal complexities, health care reform and cost containment are two issues we’ve ignored for too long, and understandably may be a bitter pill for some to swallow all at once. But a fiery debate in the Senate to find the right prescription for the ailing nation is preferred to the daily debate too many Americans face: Groceries or health care.