You are told after a certain amount of time, if you do not return to work full time, you are laid off/fired and lose your health insurance. By law, they have to offer COBRA health insurance coverage to you but that is like 3X the cost of your insurance while employed. At that point, you apply for state funded health insurance (Medicaid) and are still given a work requirement... 80 hrs a month now unless you can prove disability and it takes at least 2 years to qualify for SSD (Social Security Disability). There are some carve outs... like if you have really bad cancer, there is a Medicaid spend down for treatment, or if you are in kidney failure and need regular hemodialysis.