Some foresee ER trouble with COBRA subsidy loss

MERCED — It was becoming a typical day at Mercy Medical Center Merced's emergency room last Monday — standing room only.

At one point during the day, there were about 60 patients in an emergency room built to take 30. Health policy officials believe that it's going to get worse.

Kathleen Stoll, director of health policy for Families USA, a not-for-profit health care advocacy agency, said more people are uninsured or underinsured.

"I think we are seeing in emergency rooms across the country a confluence of factors," Stoll said. One factor is the loss of COBRA subsidies, which started Dec. 1. That loss means many laid-off Californians living on unemployment checks will be using most of that income to pay for health coverage.

COBRA provides certain former employees, retirees, spouses, former spouses and dependent children the right to temporary continuation of health coverage at group rates.

Another factor, Stoll said, is that some companies are offering their workers only health insurance with large deductibles and co-pays.

"There is a growing trend of people who are facing the double whammy of losing their job and their health insurance," Stoll said. "And even if you're employed, if you have a deductible of $5,000, you feel like you have no insurance."

Many of those people may not go to see a doctor when they become ill because they can't afford to pay upfront. When they get too sick, Stoll said, they end up in an emergency room, where they can't be turned away for not being able to pay.

Mercy's numbers Monday were a bit above average, said Robert McLaughlin, spokesman for the hospital.

On an average day there are about 145 patients, and Monday there were 153.

"Our busiest day was in the fall, with more than 200 patients," McLaughlin said.

Stoll said people who lose their jobs shouldn't assume they have no health care options. Children can be insured through federally funded programs, and some adults can get low-cost insurance, she said.