First, the coronavirus pandemic took their jobs. Then it wiped out their health insurance.

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But three weeks earlier – March 17, the day that West Virginia would become the last state to confirm its first case of coronavirus – Easley was summoned to the office of the general manager of the Four Points by Sheraton at 9:30 am. years as the hotel’s shift manager, he was told, ended in half an hour. Its health benefits ended two weeks later.

Easley, unemployed and without a health plan, and Health Right, swamped with new patients, represent a ripple effect of the new coronavirus that is sweeping the United States. In a country where most of the health coverage is linked to employment, jobs that have disappeared from the economy are wiping out insurance in the midst of a pandemic.

No one knows exactly how many people have lost their health plans, but there are clues. About 22 million workers have filed for unemployment since mid-March, according to the most recent federal figures, and that includes only those who ended up in state labor offices. obstructed. Latest census data shows that employment-based coverage made up 55% of Americans’ health insurance, although the types of work that disappear the most – restaurant and other service jobs – still have been less likely to offer health benefits.

The Economic Policy Institute, a non-partisan think tank, estimates that 9.2 million American residents were at high risk of losing their coverage in the past four weeks. Health Management Associates, a consulting firm, predicts that perhaps 12 to 35 million people will lose their employment insurance due to the pandemic, in addition to the 27.5 million who were uninsured before the virus arrived.

In the small state of West Virginia, up to 30,000 people are uninsured, according to forecasts by the consultancy.

“We see all the safety net providers going down the track like a big locomotive,” said Angie Settle, CEO of Health Right. “When you’re a free, charitable clinic, everything we have is based on grants and begging, and we’re already at full capacity.”

The clinic receives 15 to 20 calls a day from newly uninsured people looking for treatment – many of them are middle-class families, unlike its regular clientele of the working poor and homeless.

Even with what Settle calls “absolute foreclosure” of non-emergency visits, the clinic has accepted 113 new patients in the past 30 days, compared to 72 in the same period a year ago. They are not infected with the coronavirus, although the clinic is testing in a tent in the back and in a nearby soup kitchen. They just need urgent help.

The greatest pressure is on the pharmacy. Typically, Health Right spends about $ 10,000 a month on drugs, even though pharmaceutical companies donate some drugs. “And now we’re spending this a week,” said Settle.

Some existing patients want more pills, the scary drugs will become unavailable. Some drug manufacturers have increased their prices. And some people, like Easley, are turning to Health Right so that chronic illnesses don’t get out of hand.

“My battle,” said Jack Whitley, the clinic pharmacist, ” [new patients] qualify by asking for W-2, “pay stubs” and, often, proof of termination.

When Easley was still working and having a health plan in the hospitality industry, co-paying for prescriptions cost $ 140 a month, he said. If he had to buy them himself, it would cost $ 2007 a month, including more than $ 900 for insulin and syringes alone, according to figures from Health Right, which gave him the drugs for free, delivered to the edge. pavement.

“It’s a blessing,” said Easley, 56.

For a quarter of a century, he worked at the hotel across the Kanawha River, which flows through the city. After Sheraton took him over five years ago, he worked seven days a week until he started taking leave on Sunday.

He was the first to arrive in the kitchen, taking the 4:10 bus from downtown to his building in time to start at 4:30. Sometimes he stayed during the midday shift, getting enough time at 12, $ 40 an hour to earn about $ 18,000 a year.

In the morning, he and a dishwasher were summoned to the general manager, he had already prepared himself for lunch and was cleaning up. “I kind of felt like something was going on,” says Easley.

Even though West Virginia still had no Covid-19 case – Governor Jim Justice (R) was going to announce the first, 300 miles northeast of Shepherdstown, that night – the restaurant had little clients. And Easley had watched the news.

The general manager told him that he would be the first to be rehired, he said. It didn’t help him now.

Two days later, Easley was on the phone with a human resources specialist at Sheraton headquarters to review the details of the separation. She asked if he would pay the $ 299 to maintain his insurance for April.

“I don’t even have that,” he replied, not knowing how he was going to pay $ 618 in rent and utilities.

In this case, she told him, the last day of her health plan would be March 31.

“Lives are disturbed”

The largest and oldest free clinic in West Virginia, founded in 1982, West Virginia Health Right is located in a two-story brick building at the east end of Charleston, near the State Capitol.

After 23 years as a nurse practitioner, clinical coordinator and now CEO, Settle has witnessed enough economic trauma in the Kanawha Valley to fear what is to come. “I am a very optimistic person, but I do not know how we are going to recover from this,” she said. “I really don’t have one. I am scared. “

It has seen the decline of the coal industry and the closure of factories. She recently thought back to the 2014 water crisis, when a chemical used to wash coal spilled into the Elk River just upstream, forcing 300,000 people not to use contaminated tap water for days or weeks.

“Many restaurants were closed, hair salons,” she said. “And it wasn’t even across the state. Some small businesses have never recovered, and she thinks that “it will go so far now.” . . . In our region, in particular, many of these stores and various companies are not ready to support something like this. “

So far, the pressure on the clinic “is nothing,” she said. “It’s the rest that worries me. “

She knows that next month will be worse than this, once the health benefits for people end on April 30.

Among them, Greg Litvin, 53, who moved with his wife and two children to Charleston six years ago for a position as a software vendor. In August he started working for Thryv, a successor to the Yellow Pages, selling business automation and marketing plans.

On March 25, when his manager at Thryv’s Dallas head office and a human resources representative called to say that his job was being cut, most of the small local businesses that were his customers had closed.

His wife and 23-year-old son and 19-year-old daughter – both living at home – are covered by his employment in a medical supply business. His revenues have just been cut by 40% and Litvin expected to earn almost $ 80,000 for his first year with Thryv. They’re not sure if they can add it to their health plan.

The end of April 30 of his Cigna insurance policy, with his premium of $ 300 every two weeks, is a problem. A recent MRI scan showed brain damage that baffled his doctor, who referred Litvin to a neurosurgeon, who referred him to a neurologist, with whom Litvin had a telehealth appointment a few days ago.

The neurologist ordered a different MRI. Litvin tries to get it planned before the end of the month, but he’s not sure if he can. The last MRI required a participation of $ 391. It would have cost more than $ 1,400 if he had to pay for it himself, and this test was simpler than the one he needs now.

“It probably sounds very strange, but I have been more stoic about it than I thought,” said Litvin. “This is a global situation. . . . Lives are disturbed. There is a strange feeling of “I am not alone in it”. It makes me, as a husband and father, not feel so much failure. “

City people lose all kinds of jobs.

Katrina Wright had begged her husband, a union electrician, to return from Ohio, where he had been on a huge construction site, helping to build a Google data center. He agreed, knowing that the International Brotherhood of Electrical Workers authorized leave.

A few mornings later, she fired the two women who worked with her in her small cleaning business, fearing that they and their families might be exposed to the virus and that they might expose their customers. Early that evening, she sent a message to her customers, “With a heavy heart as a business owner during this life-changing pandemic, we will close indefinitely. . . . At the end of the day, we have to take care of our customers and ourselves. We will do our part to smooth the curve. Please understand our decision and keep us all in our prayers. “

If her husband continued to contribute to the union health fund, he could still get his family insurance, but that would cost $ 1,000 a month, and the only money coming into the house now is $ 1,200 in Pennsylvania unemployment benefits, where he was working last year. He failed to contact the West Virginia workforce agency.

They therefore became uninsured on April 1, even though everyone needs care. Her 13 year old son is autistic. Her daughter suffers from migraines with symptoms that mimic a stroke. At 50, her husband has Raynaud’s phenomenon, a disorder in which the blood vessels spasm, causing a decrease in blood flow by cold or under stress. At 39, she was treated for high cholesterol and slightly high blood pressure.

Wright has always read medical information, not wanting to be a mother who rushes her children to the doctor.

Still, she said, “It’s scary. I can only treat as much at home. “

Tears on payday

Anthony Paranzino is the only employer he still knows to pay for health benefits.

He owns Tony the Tailor, a sophisticated men’s clothing store in an old Masonic temple building in the center of historic Charleston. His father opened it as a tailor shop in 1974, and Paranzino started working there at the age of 9, learning the trade of tailoring until they turned to selling high-end costumes. , and his father handed over the business in the early 1990s.

Normally, he has two employees, as well as his wife and a retired wife who are still helping. At the beginning of March, the clothing sector was already suffering. It was impossible to obtain tissue from Italy or components from China – a country that the coronavirus invaded earlier than in the United States.

The last day of store opening was March 13. He thought his workers would be on leave and then let them apply for unemployment benefits before there were too many people.

On Thursday evening, he always wrote his paychecks. Paranzino said next Thursday, “I cried like a baby. It was the first time that I hadn’t had to pay on Thursday evening in thirty years. This is where reality settled. ”

He continues to pay for health insurance. Usually, he pays half the premiums of his employees, but he collects 100% at the moment. “They are great employees, I didn’t want to let them hang. “

It costs him $ 2,361 a month. “I can’t do it indefinitely,” he said, with sales volume down 70%, even though some online orders still arrive.

Near his store in the historic district, only the bank crossing the street is open. A new branch of the University of West Virginia Faculty of Law is closed. The same is true for a political consultancy and Art Emporium, a gallery and a framing shop behind him. One block on Capitol Street, bars are closed, and some restaurants are open for curbside pickup only.

These mostly non-sight-seeing workplaces gave Paranzino the idea of ​​a non-profit organization he just formed with a lawyer friend. Using their empty store as their headquarters, they raise funds for laid-off workers in the service industry, to give them some help with rent, food or utilities. Since the effort began a few weeks ago, approximately 500 people have applied. The project raised $ 26,500 and sent $ 10,500 in rent assistance and $ 6,000 in $ 50 Kroger grocery cards.

The high cost of a pandemic

Health Right tests in the tent and soup kitchen did not detect anyone with the coronavirus, although 111 people in Kanawha County tested positive, most of them in the state. Across the street from the clinic, the Charleston Area Medical Center Memorial Hospital saw the only 19 patients in the area sick enough to need this care. The hospital admitted 27 infected patients. Ten are still there. Sixteen were released. One is dead.

The hospital was luckier than many. According to Dale Witt, the hospital spokesman, none of the 19 patients he admitted admitted lacked health insurance.

Nationally, an analysis by the Kaiser Family Foundation, a health policy group, has estimated that, throughout the pandemic, uninsured coronavirus patients will cost hospitals $ 13.9 billion to 41 $ 8 billion.

On April 3, Vice President Pence announced that the Trump administration plans to pay hospitals for the treatment of uninsured coronavirus patients, drawing on part of a recently designated $ 100 billion fund. by Congress for hospitals and other health care providers strained by the pandemic. There are no details yet.

Even if these payments came, they would be lower than hospitals paid for privately insured patients, and uninsured patients would be “still struggling” for bills from doctors who treat them at the hospital, said Larry Levitt , Kaiser’s executive vice president for health policy.

Under the Affordable Care Act, people who lose their jobs are entitled to a special registration period to purchase a health plan, if they can afford it, through the federal insurance market created by the law. President Trump, an enemy of the ACA, resisted calls to open HealthCare.gov, the online registration system available more widely, for six weeks at the end of the year.

Finally, some unemployed people can join Medicaid, a public insurance for the poor, if their incomes are low enough. Thresholds vary by state.

For the time being, some dismissed workers are eligible for COBRA, transitional coverage in the event of job loss. Thryv offered COBRA to Litvin. When he checked the premiums, he discovered that medical and dental coverage would cost him nearly $ 800 a month.

“It’s astronomical,” he said.

Knowing that government assistance in resuming insurance is fragmentary and uncertain, Settle at Health Right is preparing for an intensification of the attack.

In the past few weeks, the clinic has sent a dozen emergency requests for additional grants to foundations and others who help it support themselves in normal times.

As for Easley, he is grateful to an old friend who told him that Health Right could help him with his medication.

But he finds his mornings depressing without the hotel kitchen. “Everyone’s calling and checking to see how I’m doing,” he said, “because I fed all of these people. “

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