One thing I want to know.

[Ms. Toad]

18. COBRA was an option - BUT - it initially appeared it would not be,

and we weren't notified it was until 2 months after the job ended.

The issue is that COBRA isn't available in bankruptcy when the business is completely terminating (which this one did). HR stopped responding to inquiries pretty much the day the notice of liquidation came out, and about a month after the stores in our area were completely shut down we discovered that employees might actually be entitled to pay for 2 months (some employees got notices to that effect - no explanation why they were eligible, no notice to the employees at other stores). It turned out that a few stores were large enough to have required a 2-month notice . . . that apparently made everyone eligible for COBRA since they had to continue the health care plan for those employees, so about a month later we finally got a notice about COBRA.

Even with the higher premium, the COBRA plan they offered would have been a better deal, since she had already met her out of pocket maximum for the year. Her medical expenses are approximately $17,000/month. So she had $2000 out of pocket (OOP) in July, when her old plan started, $2000 in March when she was forced out of work and onto the ACA, and $3500 in June when she was eligible for the work plan (or $6,000 more under the ACA if she continued it, since she lost the subsidy when a work plan became available) then $3500 more in October when the new work plan year started.

So COBRA would have saved her $5500 in medical paymentns. For those months it would have cost about $3250 more in premiums for COBRA, so still a better deal. Unfortunately - BUT - at $17,000 bucks a month in medical care, we could not go without a plan hoping they might offer a retroactive COBRA plan.

That entire process was a nightmare - we even got our senators involved (one of whom was involved in writing the ACA), and his office was not even aware that there are both premium subsidies and cost sharing subsidies. That rendered them incapable of answering the question we asked about whether the cost sharing subsidies would disappear when she became eligible for work insurance (they do . . . we had hoped she would be able to stay on the ACA without subsidies to take advantage of having already hit her OOP maimum, but not only did the premiums jump $100/month, she would have had to pay the difference between the $2000 subsidized cap and the $8,000 unsubsidized cap.) I even went back and read the law to see if we could get an answer. Ultimately, we had to sign up for the first unsubsidized month, see the OOP max jump, and then cancel it.

This isn't an issue for most people - most people don't have $20,000 infusions every 7 weeks + MRIs, colonoscopies, and expensive medication. So most people don't reach the $2,000 OOP, let alon an $8,000 one in a single month. So insurance agents aren't used to looking at insurance by adding hte OOP max to the premium to get the price for a month or two of gap insurance - and they aren't used to answering the kind of questions we asked about what happens to the cost-sharing subsidies once you become eligible for a work plan.

Every single person told us - we'll just have to wait until that happens and then we'll see what the system generates. Really??? There are rules that govern it. I want to know what the rules are, since it I've had "systems" that were programmed incorrectly - and, at least theoretically, the system implements the rules as they are programmed in. But no one, even my senator's office, could tell me the actual rules - and most told me I was crazy for even asking the question (only the premiums will go up since you pick the OOP as part of the plan. Wrong.)

As for Public Option/MFA - they should be cheaper thant he ACA, since they cut out the insurance companies. Our medical costs are the highest in the world in part because the cash costs are higher to underwrite the discounts under insurance contracts and the uncollectable costs. Those largely vanish once the government is paying directly for the care, virtually all bills are paid, and cash prices don't have to be jacked up to cover the other two.