So Ms. Childers, 30, signed up for Cobra, which lets laid-off workers stay on their former employer’s health plan for 18 months under federal law, but requires them to pay the full cost unless the employer chooses to help. She is paying $560 a month — substantially more than a subsidized plan would cost at her income level, and an amount she will not be able to afford for long. She has several autoimmune conditions, and without insurance, would owe at least $3,000 a month just for her oral medications; she also gets regular infusions that cost even more.
“If my unemployment runs out and I don’t have a job,” she said, “I don’t know what I’ll do.”
In contrast, most of the 13 states that operate their own A.C.A. marketplaces not only opened enrollment to everyone during the pandemic, but worked hard to publicize the option. In California, where