Health

WASHINGTON - The Obama administration rushed to include a health care safety net for laid-off workers in the recently signed stimulus bill, but has not told employers exactly how to make it work.As a result, tens of thousands of jobless people could wait months before getting help paying for health insurance that their employers previously had covered.

"Too many people are still trying to figure this out," said Heath Weems, director of human resources policy at the National Association of Manufacturers. "There is a lot of confusion."At issue is the program called COBRA, the acronym for the law that allows workers to keep their company's health insurance plan for 18 months after they leave their job, if they pay the premiums.

The policies are so expensive that only a minority of eligible workers sign up, often those with medical conditions that demand attention. Costs for a family of four can top $1,000 per month.A $25 billion provision in the stimulus bill aimed to cut COBRA's price tag, reducing its cost by 65 percent for workers laid off as far back as Sept. 1.The bill gives eligible workers 60 days to apply.

Then they get the reduced-cost premium for nine months.But it's not going to happen right away.Employers are waiting for instructions from the Labor Department and the Internal Revenue Service on how to put the program into place. Both agencies posted some information online Thursday.Until employers get the guidance they need and notify potentially eligible ex-employees, most workers will not apply for the new benefit. Many probably will not know it exists.

Left waiting are people such as Cassandra J. Kelsey, 55. The District of Columbia resident lost her job with Verizon in January. She says she can barely pay her rent and is eating less to save money to cover the $550 a month premium to keep her health coverage under COBRA.Kelsey walks with a cane and lists a litany of ailments, including degenerative arthritis and hypertension.

For her, going without health insurance is unthinkable.Outside a D.C. career center on a recent morning, Kelsey clutched copies of her COBRA invoice, clippings from a local newspaper about the stimulus bill and a form letter she received from the White House after writing to Obama about her troubles.

Kelsey knew about the reduced premium and said it would bring her COBRA costs below $200 a month. But when she called her benefits department, she was distressed to learn that she would not be able to get the reduced cost immediately, probably not until May."I can't take advantage of it now which I think is totally unfair," Kelsey said. "I don't know how I'm going to make it."The stimulus bill contemplated that workers might not get the reduced premium immediately, and contains a provision that would allow them to be reimbursed later on.

That would be little help to Kelsey and others who need the benefit now.An IRS spokesman said the agency is moving as fast as it can. A Labor Department spokeswoman responded to questions with an e-mail linking to a short agency fact sheet.One question that employers are struggling with is how to go back and find employees who were laid off as far back as September.Also, the legislation says only workers who were "involuntarily terminated" are eligible, but never defines that term.

Does it include only people who are laid off? Or those who take buyouts offered by their employers?No one knows how many people will actually seek a share of the stimulus money to pay their COBRA premiums. Congressional experts estimated 7 million, but that may be too high.Advocates fear that even cut-rate COBRA could prove too little, too late for some jobless Americans."For many people it will remain unaffordable," said Ron Pollack, executive director of Families US