As of tomorrow I will no longer have health insurance. I have been with Kaiser my entire life. I'm not a huge fan of Kaiser personally, I think they have a lot of flaws and I think health insurance is a real racket, but even with less-than-ideal coverage, having health insurance is better than not.

Of course now that I am unemployed my former employer is no longer paying for my health coverage. I received my COBRA packet in the mail informing me of my options there. While I find the COBRA packet about as perplexing as I found the EDD website, it appears to say the following. I qualify for a reduced rate from the rate my former employer paid. My reduced rate appears to be $287 per month. It appears that I qualify for this reduced rate because my employment was ended involuntarily, and it appears that this reduced rate is available to me for a temporary amount of time. I cannot tell whether that temporary amount of time is six months or eighteen months or somewhere in-between. And there also appears to be the possibility that I qualify for an even more reduced rate than $287 a month because my employer initially miscategorized my reason for unemployment.

For now and until I am able to look into it further, let's assume I qualify for COBRA subsidized health insurance of $287 a month. If you've been reading my blog you know that I believe I'll have "disposable income" of about $300 a month after paying for the necessities of my current life. And you are aware that I am likely dedicating that $300 to working to pay off my credit card debt.

It is certainly a sad state of affairs when a person has to choose between having health insurance and paying off their debt. It is a sad time for this country when it's neighboring Canada, many (all?) countries in the EU, even Israel, all provide public health care while America, the leader of the free world, does not.


I cannot afford to pay for health care and pay off my debt. And while it is a gamble, I am certain to screw myself financially, maybe for the rest of my life, if I shirk my responsibility to my credit cars companies. It is a game of Russian Roulette to not have any health insurance at all. If nothing happens to me I'll get by fine, but if an emergency arises and I have to go to the hospital I can easily rack up $5,000, $10,000, even $20,000 in debt with one hospital visit. That's not a risk I'm happy to take.

Luckily for me I live in San Francisco. San Francisco has its own public health care program called Healthy San Francisco. www.healthysanfrancisco.org. The basic qualifications appear to be that you earn less than approximately $55,000 a year and that you have been uninsured for 90 days at the time you apply. You do have to pay into the program a bit based on your income. For many qualifying persons you pay nothing, and for me it looks like my payment will be $80 a quarter, which comes out to $320 a year for Healthy San Francisco as opposed to nearly $300 a month for private insurance.

The program cautions you that if you have private health insurance you shouldn't cancel it to take advantage of the program, as private health insurance will provide more and better coverage. Still, for someone like me who cannot afford private health insurance, this option is WAY better than not having health insurance at all.

Since I typically go to the doctor for things like yearly OBGYN check-ups and the occasional symptom-related issue, I don't think I will experience a significant difference in the level of care or the options available to me between Kaiser and Healthy San Francisco. And absent an unforeseen emergency (knock on wood), I will be able to get through three months of no insurance at all in order to qualify for the program.

I do have a couple of questions that I need to look into. One is the issue of "pre-existing conditions." I don't have any major health issues, but I've had my share of random things I've been treated for such as tendinitis, non-allergic rhinitis, and other random odds and ends. These "pre-existing conditions" may exclude me from qualifying for private health insurance in the future. One would assume that some day I will be working again, whether for myself or for an employer, and that at that time I will earn too much money to qualify for Healthy San Francisco and I'll have to then sign up for private health insurance. If my "pre-existing conditions" will cause my then-health coverage to be some ridiculous amount like $900 a month then I have a problem and am making a choice now that will potentially really screw me in the future.

But then, in having to choose between paying my debt and paying for private insurance, what choice do I really have?

Another option I have been told to look into is trying to get on my boyfriend's health insurance. While we are not registered domestic partners (that option is not available to heterosexual couples in California), some companies recognize other types of domestic partnerships for health coverage purposes. If my boyfriend informs his company that he has a domestic partner (because we live together), depending on his company's policy I may be able to be covered by his health insurance. I would still have to pay something, but it would likely be more like $80 a month, which is a lot more reasonable to work into my budget than $287.

So the good news is I have options. Whether in the short or long run and whether with better or worse coverage, I will be able to be covered by health insurance despite my unemployment. Unfortunately not all Americans today can say the same.