At a Glance | August 20, 2020 COBRA Beneficiaries Are Less Healthy and Spend More An examination of claims data shows dramatic differences between beneficiaries covered by a COBRA policy and those covered through a full-time employed worker. SPENDING COBRA Enrollees Spend More on Health Care Claims data show that Consolidated Omnibus Budget Policy via a Full-Time Employee COBRA Beneficiary Reconciliation Act (COBRA) $6.7k $18.7k Individual Spending enrollees spent more on health care than employees still $19.3k $26.6k Family Spending receiving health insurance benefits through their employer. HEALTH STATUS COBRA Enrollees Are Older and Tend to Be Less Healthy The data show evidence of COBRA Beneficiary Policy via a Full-Time Employee adverse selection: Those who receive coverage through Average Age of 42.6 Yrs Old 50 Yrs Old Beneficiary COBRA more frequently have chronic conditions that are Charlson 0.32 Average CCI 0.66 Average CCI 1 Comorbidity Index expensive to treat. HEALTH CARE USAGE COBRA Enrollees Use Health Care More Frequently COBRA claimants are heavier Policy via a Full-Time Employee COBRA Beneficiary users of both inpatient and Frequency Spending Frequency Spending outpatient services. COBRA enrollees with individual Hospital Admissions 10.2 3.8 — — coverage had nearly five per 100 enrollees times the hospital days of Hospital Days 78.0 16.5 $1,111 $4,313 those covered through a per 100 enrollees full-time employee. And ER Visits 40.0 35.8 $306 $451 they spent more than twice as per 100 enrollees much on prescription drugs. 6.7 Doctors’ Office Visits 4.1 $480 $836 30.0 Prescription Drug Fills 17.3 $1,707 $4,130 2.2 Blood Test, Panel 1.3 $110 $214 2.5 Physical Therapy Visits 1.1 $130 $313 2.4 Psychotherapist Visits 0.6 $75 $397 1. CCI is an index comprised of the following conditions: acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, dementia, chronic obstructive pulmonary disease (COPD), rheumatoid disease, peptic ulcer, mild liver disease, diabetes, hemiplegia or paraplegia, renal disease, cancer, moderate/severe liver disease, and AIDS. SOURCE: Jake Spiegel and Paul Fronstin, “COBRA: A Closer Look at Who Enrolls and the Case for Subsidies,” EBRI Issue Brief, no. 508 (Employee Benefit Research Institute, July 9, 2020). © 2020 EBRI This report is copyrighted by the Employee Benefit Research Institute (EBRI). You may copy, print, or download this report solely for personal and noncommercial use, provided that all hard copies retain any and all copyright and other applicable notices contained therein, and you may cite or quote small portions of the report provided that you do so verbatim and with proper citation. Any use beyond the scope of the foregoing requires EBRI’s prior express permission. For permissions, please contact EBRI at permissions@ebri.org.