Losing a job can be a devastating blow to anyone, and especially in these tough economic times. Not only is there income to make up, but job loss also frequently means losing one’s health insurance coverage.

One way the government helps to mitigate this double blow is COBRA, which allows workers and their families who lose health benefits due to a job loss to continue on their former employer’s health insurance plan for up to 18 months. Often the employee must pay the full premium, but for some families, this is the only way to maintain health insurance.

One of the provisions in the economic stimulus bill, the American Recovery and Reinvestment Act, that was signed into law last February provided a 65% subsidy for recently unemployed workers making use of COBRA. This subsidy quietly ended for many people on December 1, drowned out in the media by the health care reform debate.

The end of this subsidy has an interesting impact on rural communities. Only businesses with more than 20 employees are required to offer COBRA. Because rural jobs are predominately created by small businesses, self-employed individuals and entrepreneurs, many rural workers are not eligible for the subsidy.

There are, of course, businesses that allow former employees to use COBRA even if they aren’t required, but this cannot happen if the small business no longer exists. And there is nothing that COBRA can do for self-employed workers.

There has been a significant amount of discussion during the health care reform debate about the desire to maintain the employer-based health care system that many Americans use. As we consider how rural communities are impacted by the recession and by health care reform, it’s important for us to keep in mind that many rural workers don’t rely on their employers for health care.