Over one-quarter of a million jobs were lost in the U.S. in September 2009. Because unemployment quickly morphs into uninsurance, a question for the 263,000 workers and their families is: “Will Medicaid be able to cover me and my family if I cannot afford COBRA?”

There are three pieces of arithmetic that can help us connect the dots to answer this question:

1. On average, the monthly cost of COBRA consumes 84% of the average monthly unemployment payment in the U.S. The ARRA stimulus package included a 65% subsidy to help newly-laid off people pay for COBRA if they elected to do so and earned less than $125,000. This programs covers people laid off to 12/31/09, and covers those who are eligible and opt-in for a period of nine months.

2. For every 1% increase in unemployment, there is a 1.1 million person increase in the uninsured and a 1 million person increase in Medicaid and SCHIP. This metric was calculated by the Kaiser Commission on Medicaid and the Uninsured in April 2008, shown in the graphic.

3. Governors have to balance their state budgets under the law and cannot run deficits. The recession has decimated most state budgets due to lower tax receipts accompanied by increasing demand for services — like health, education, and social services as citizens lose jobs. The Washington Post discussed the painful burdens of governors earlier this month, noting that the National Governors Association is lobbying hard against any additional unfunded mandates for health and other programs.

Health Populi’s Hot Points:
Time for the Kaiser team to update their metric on 1% = 1.1 + 1. The “1 million people” expected to be absorbed by Medicaid is now unsustainable given the depth and length of the recession. The U.S. has lost about 6,582,000 jobs since January 2008. The rate of job losses in the past six months hasn’t dramatically slowed — we lost 467,000 jobs in July, 466,000 jobs in August, and 263,000 jobs in September — so over 1 million jobs lost in just the past 3 months.

One job that’s dealing with this intensely is the Governor’s — having to dial down services when more are being demanded. Expect Medicaid to foist off prospective enrollees to the uninsured rolls in this so-called “jobless recovery.”