Those who must rely on COBRA coverage do so by paying the full cost which includes the portion reviously covered by the employer. Loss of employment is most likely the reason, so they have unemployment benefits and whatever income they can make on the side to pay that with. That was me during the Obama Economic Crash of 2008. People in this situation need and should be afforded every possible consideration. P.S. Single Payer is a farce and would be the single most destructive decision possible with regard to healthcare quality. One need only look at the U.K. to see the results.