GOP health plan threatens workers’ flexibility

In recent years, millions of middle- and working-class Americans have moved from job to job, some staying with one company for shorter stints or shifting careers midstream.

The Affordable Care Act has enabled many of those workers to get transitional coverage that provides a bridge to the next phase of their lives — a stopgap to get health insurance if they leave a job, are laid off, start a business or retire early.

If the Republican replacement plan approved by the House becomes law, changing jobs or careers could become much more difficult.

Across the nation, Americans in their 50s and early 60s, still too young to qualify for Medicare, could be hit hard by soaring insurance costs, especially people now eligible for generous subsidies through the existing federal health care law.

This news scares Fern Warnat, 59. She has gotten insurance on the federal marketplace a couple of times in the last few years. When she and her husband moved from New York to Boca Raton, Florida, she bought a policy for a few months to tide her over until she got coverage from a new job. A year later, she needed to buy insurance again when she found herself unemployed. The policy was expensive — around $800 a month.

“It wasn’t easy, but it was available,” she said.

Now she worries what would happen under the Republican plan if she left her job at a home health company that provides insurance.

“I need something to be there,” she said. “I’m going to be 60 years old. All my conditions pre-exist.”

Since the Affordable Care Act was enacted, companies have become less worried about people who want to leave but feel locked into their jobs because of health insurance, said Julie Stone, who works with corporations at Willis Towers Watson, a benefits consultant. The law “removed one of the barriers to leaving your job,” she said.

Fewer employers now offer health insurance for their retirees, she said. The other alternative is COBRA, the federal law that requires companies to allow workers to remain on their employer’s plan if they pay the full monthly premiums, which are often extremely expensive and out of reach for many peo-

AMANDA LUCIER / THE NEW YORK TIMES Dr. Marie Valleroy suffers from multiple sclerosis but was able to stop working because of the Affordable Care Act. People in transition because of layoffs, moves, illness or new ventures turned to the federal marketplaces as a stopgap health...