Sara Horowitz

Middle Class, Earning a Living—and Uninsured

When Massachusetts policy makers announced last year that they'd require every state resident to have health insurance, alarms sounded in my head. Sure, low-income people would be covered, as they are now by Medicaid. And the rich can generally afford health insurance premiums (even as prices zoom past inflation).

But what about the middle class?

Here in New York, where a comprehensive plan for an individual averages around $1,000 a month, lots of middle-income people decide to gamble and not buy insurance. In the realm of household economics, it's a calculated risk.

So it was reassuring to see this month that the Commonwealth Connector--the Massachusetts body overseeing the mandatory coverage plan--capped premiums for people earning up to $50,000.

While the Connector has done the right thing by proposing a solution for the middle class, the Massachusetts situation only serves as a foil to a very real problem: most of the time, the uninsured middle class is ignored. People who can't get health insurance through an employer--freelancers, independent contractors, and the like--are the ones with no help at all. Middle class workers don't get support from the government, and are the most likely to be bankrupted by a medical catastrophe.

In the national conversation about health care, these are the folks we need to be talking about. The rich will always be able to afford private insurance, and we can cover the poor through government programs. But unless a proposal specifically provides for the ones in the middle, as the Connector is doing, they're all too likely to fall through the cracks.

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Posted at 6:00 AM, Apr 27, 2007 in Health Care
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