When I spoke with Suzanne Geisler on Thursday, she still didn’t know what she was going to do about health insurance. Geisler, 60, is an educational consultant who conducts presentations on environmental topics for schoolchildren. She lost all her bookings when the Ohio schools closed due to the coronavirus pandemic. At the same time, her husband lost his job as a facilities manager for a national nonprofit.

“We still don’t know how much the COBRA is going to be. We don’t know if our unemployment has been accepted, we don’t know how much we’re going to get, we haven’t gotten any checks or any communication," she said.

“Everything’s just collapsed.”

It seems like it was years, not mere months ago that former vice president and presumptive Democratic presidential nominee Joe Biden dumped on Medicare-for-all. He claimed that “160 million people like their private insurance” and that he didn’t want union members to be forced to give up the health insurance they bargained hard to receive. “You should be entitled to keep it, and no plan should take it away from you.”

Ten million — and counting — unemployed Americans later, we’re learning the limits of all that.

Like it or loathe it, millions of people have been suddenly and unexpectedly severed from their health insurance. Unions are offering some protection but not in perpetuity — members of Las Vegas’s powerful Culinary Union who were laid off in March are guaranteed health insurance through Aug. 31 only.

The question of what people should do next is complex and fraught. COBRA — that is, extending workplace insurance — is costly. Navigating the Affordable Care Act exchanges — unemployment is considered a qualifying event — is difficult in the best of circumstances, and now all but requires a psychic’s crystal ball. ACA subsidies depend on annual income, and someone who lost their job in the coronavirus pandemic does not know what that will be. Guess too low, and the applicant could owe the government money next year. Guess too high, and that applicant might not be able to afford it at all. Medicaid eligibility varies by state and is subject to asset tests. It seems almost certain many will ultimately decide to go without and hope for the best.

President Trump and the Republicans are making things worse, as they so often do. The administration is continuing to support yet another attempt to overturn the Affordable Care Act. Oklahoma Gov. Kevin Stitt is still pursuing Medicaid work requirements — something that reeks of Dickensian cruelty in an economy that is shedding millions of jobs a week. Nor will Trump take meaningful steps to crack down on relentless profiteering, with the result that hospitals are paying multitudes more than they should for desperately needed equipment.

Trump has also refused to reopen the ACA exchanges, something that will result in the suddenly unemployed needing to prove their status — in a system, mind you, that often can’t even process their claims — before receiving coverage. When asked about it at Thursday’s coronavirus task force briefing, it was clear Trump had no idea what he was talking about. “We’re doing better than that. We’re going to try to get a cash payment to the people,” he responded, like a game show host revealing the sucker’s prize behind Door No. Two.

The for-profit medical system, the one we are constantly, falsely assured is the best in the world, is buckling under the strain of the pandemic. One analysis of the health insurance markets performed by Covered California, the state’s health-care exchange, found that without a government bailout, premium costs could increase by up to 40 percent in 2021 — something that could potentially impact everyone not eligible for Medicare.

It doesn’t take a lot of imagination to suspect that the coronavirus will undercut support for the United States’ expensive, jerry-rigged and increasingly frayed health insurance system. A poll conducted by Gallup in November 2018 found that 7 out of 10 Americans agreed the health-care system was “in a state of crisis” or suffering from “major problems.” Hardly a ringing endorsement — and that was in relatively good economic times. Since the coronavirus pandemic hit, one survey shows support for Medicare-for-all is on an upswing.

Our for-profit health insurance system is actually a historical accident, a product of World War II, when labor shortages were common and the government banned pay raises. Companies, in an effort to stand out, began to offer health insurance as a benefit. It seems fitting that another historic job crisis will up the pressure to replace it with a more just and universal system.

For Suzanne Geisler, that can’t happen soon enough. “I have a very hopeful thought that this is going to change the conversation after this. Look at all of us who have lost our insurance. Look at all of us who have lost our jobs. This is going to be a game-changer,” she said. “I hope.”

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