Update benefits and assure care for the jobless
By MERTON C. BERNSTEIN
Kansas City Star
Jan. 17, 2009 10:15 PM
Growing unemployment threatens workers, their families and the economy.
Losing work income degrades family purchasing power and business income. Task one: Improve cash benefits to bolster both.
And the unemployed and their families need assured health care. Being out of work increases the chance of illness and injury while decreasing the ability to cope with it.
The protection of COBRA (the statute enabling job losers to continue their job-based health insurance for six months) only reaches companies with more than 20 employees.
And it shifts premium payments from the former employer to unemployed persons, many of whom find them unaffordable.
Although we know that job loss imperils the fiscal, physical and mental health of the unemployed, statutory unemployment benefits have fallen further and further behind wages. Cash benefits require updating ASAP.
All of the unemployed and their families should be assured medically necessary services, including preventive care like vaccination.
Such an approach dispenses with the costly means-testing now required to qualify for SCHIP (the State Child Health Insurance Program) and for Medicaid.
Ascertaining eligibility costs billions of dollars. One study of SCHIP and Medicaid found that determining eligibility costs up to $280 a child. That does not take account of the costs of re-qualifying every 13 weeks.
The idea of using Medicaid to tide over the unemployed, reportedly under consideration by the Obama transition team, will not work, partly because the application process takes time.
Moreover, the recession has slowed the flow of paying patients to health-care providers.
That imperils the financial health of many hospitals, especially community hospitals that often live on the fiscal edge.
When facilities are not fully utilized, it is a good time to play health-care catch-up for millions who put off medical care because they lacked the ability to pay.
It is also a good time to provide more people with the skills that an expanded health-care system will require.
Medicare (but without deductibles and co-pays) is the best vehicle to cover the unemployed. It is low-cost and already in place, and health-care providers know how it works.
An unemployment insurance program with assured health care will bolster the economy as it helps people through one of the roughest episodes of their lives.
Merton C. Bernstein, Coles professor of law emeritus at Washington University, served as principal consultant to the National Commission on Social Security Reform (1982-1983) and was a founding board member of the National Academy of Social Insurance.