It’s honestly bonkers to me to discover that — because of what Congress did — the most cost-effective health care option available to us, now that my husband has just lost his job, is… COBRA.

COBRA was virtually never the best option before the ACA. It was what you did as a bridge, or — in my case — because “preexisting conditions” were still legal grounds for excluding you from a new plan.

Sure, there were continuity-of-care and provider-network reasons to bear the full cost of your former employer’s plan. But cheaper? The fact that this is even a possibility is staggering.¹

And it makes me very nervous about what happens if neither of us has employer-based coverage by the end of next year, when COBRA eligibility ends. I never received a formal SSA disability designation and am now starting that process; they tell me it should get backdated so I’ll qualify for Medicare — but “should” is doing a lot of work in that sentence.

I know: I’m grateful we have sufficient savings to even consider this option, rather than being forced to roll the dice on a Marketplace plan and figure out which medications I can stop taking to make ends meet without, you know, dying. Many people don’t have even that, and have been living this nightmare for months.

I was righteously indignant before because I could run the numbers and imagine this circumstance. Now that I’m in it, I am pissed.

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¹ Addendum 16:00 EDT: Coming back with my amateur economist hat on, because I just can’t help myself:

I think I see how the economics of this work out in a way that’s at least internally consistent: the gross population of employees and their families who want health insurance is, on average, healthier than the population without access to employer-based coverage. So the cost differential is aligned as you’d expect when subsidies are withdrawn and some pre-pandemic provisions — coverage limits, clawbacks — come back into effect.

But ethically, that’s obviously just nuts, and is exactly opposite of what Congress intended in enacting the ACA in the first place.