By Rebecca Kolins Givan

As the tidal wave of job loss swells, ahead of the peak of illness and death, a staggering number of workers are losing their health insurance when they need it the most.

A new report by the Economic Policy Institute estimates more than 147,000 New Jerseyans and their dependents have lost their employer-sponsored health insurance during the last two weeks. That’s about 40% of the 361,000 workers who have filed for unemployment benefits in our state since March 15.

Nationally, EPI estimates 3.5 million of the 150 million Americans with employer-sponsored insurance have seen it vanish since the crisis worsened. Without government intervention, these workers will be left scrambling for healthcare access through uneven state Medicaid programs or the Affordable Care Act exchanges.

At least New Jerseyans have a better safety net in the NJ FamilyCare program than workers in many other parts of the country. In Florida, Texas, and 12 other states that have declined to expand Medicaid, millions of people are ineligible for Medicaid, and many more are unable to afford individual plans offered on the exchange.

Hotel and restaurant workers are among those taking the biggest hit so far. UNITE HERE, the mighty, fighting hospitality workers’ union, estimates that 80% to 90% of its members will ultimately lose their job because of the pandemic. That includes thousands of people who worked in Atlantic City’s now-shuttered casinos. They are desperately advocating for the federal government to step in and replace the employer contribution to their health insurance premiums while facing the nightmare scenario of going uninsured during a global health crisis.

Workers in the arts, entertainment, and recreation sectors are also losing their insurance by the thousands. Actors and musicians receive health coverage through their union benefit funds, but only if they work a minimum number of shows each year. With productions canceled, they cannot hit their targets.

There is no good rationale for tying healthcare access to the ups and downs of the labor market. Imagine if losing your job meant that your child could no longer attend elementary school, or that the fire department would not show up if you had an emergency. We don’t provide public school education, emergency services, or highway access based on employment, but that’s the way half of Americans get their health insurance. There has to be a better way.

In the presidential primary race, healthcare emerged as the key fault line between Democrats. Several candidates, including Joe Biden, argued fervently for the continued primacy of employer-sponsored health insurance. Biden positions himself as an ally of the unionized workers who fought hard for their health insurance at the bargaining table and who fear the strawman of “government healthcare.”

Bernie Sanders continues to push for single-payer healthcare, a national health insurance program that would cover all Americans just as Medicare covers all seniors. Single-payer, or Medicare for All, would mean liberation from the heartbreaking precarity of health insurance tied to employment.

A single-payer system would ensure coverage for hourly and tipped workers like the cooks, servers, and casino workers who recently lost their jobs, and it would pull in segments of the labor force that never had health insurance to begin with. For example, many gig economy companies like DoorDash, Instacart, and Uber intentionally misclassify their workers as independent contractors, making them ineligible for employer-sponsored health insurance.

Even public sector workers would benefit from single-payer healthcare. Although most public employees participate in state benefit programs, their health care costs have been creeping up to the point where coverage is no longer affordable for many.

The COVID-19 pandemic and the record number of Americans filing for unemployment benefits should serve as a wake-up call. It’s bad enough to lose your job. It’s devastating to lose your health insurance along with it.

If health care was treated as a right, not a privilege tied to employment, no one would have to face the devastating, secondary diagnosis of that uniquely American disease: medical bankruptcy.

Rebecca Kolins Givan is an associate professor in the School of Management and Labor Relations at the Rutgers, the State University of New Jersey. She is the author of The Challenge to Change: Reforming Health Care on the Frontline in the United States and the United Kingdom.

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