WASHINGTON – Cassandra J. Kelsey has tried to cut back on all her expenses since losing her job in January. But suffering from degenerative arthritis, she can’t do without health care. That’s why the 55-year-old District of Columbia resident was excited when President Barack Obama’s economic stimulus bill included a provision to slash costs for laid-off workers’ health insurance. And that’s why she was distressed to learn that, because the Obama administration has yet to tell employers exactly how to make the benefit work, it’ll be weeks or months before she can claim it. ‘I don’t know how I’m going to make it,’ Kelsey said. At issue is a program known as COBRA that allows workers to keep their company’s health insurance plan for 18 months after they leave their job, if they pay the premiums. The policies are so expensive that only a minority of eligible workers sign up, and they are often those with medical conditions that demand attention. Costs for a family of four can top $1,000 per month. A $25 billion provision in the stimulus bill aims to cut COBRA’s price tag, reducing its cost by 65 percent for workers laid off as far back as Sept. 1. The bill gives eligible workers 60 days to apply. Then they get the reduced-cost premium for nine months. But it’s not going to happen right away. Employers are waiting for instructions from the Labor Department and the Internal Revenue Service on how to put the program into place. Both agencies put information online Thursday. Until employers get the guidance they need and notify potentially eligible ex-employees, most workers will not be able to apply for the new benefit. Many probably will not know it exists. ‘Too many people are still trying to figure this out,’ said Heath Weems, director of human resources policy at the National Association of Manufacturers, an industrial trade association. ‘There is a lot of confusion.’ Left waiting are people like Kelsey, who is now unemployed after spending nine years working for Verizon. On a recent morning Kelsey stood leaning on her cane outside a Washington career center, clutching copies of her COBRA invoice, clippings from a local newspaper about the stimulus bill and a form letter she received from the White House after writing to Obama about her troubles. Kelsey knew about the reduced premium and said it would bring her COBRA costs from a nearly unreachable $550 a month to below $200. But when she called her benefits department, she learned that she probably wouldn’t get the reduced cost until May. ‘I can’t take advantage of it now, which I think is totally unfair,’ Kelsey said. Under the stimulus bill, workers unable to get the reduced premium immediately may be reimbursed later. That would be little help to Kelsey and others who need the benefit now. An IRS spokesman said the agency is moving as fast as it can. A Labor Department spokeswoman responded to questions by e-mailing a link to a short agency fact sheet. One question that employers are struggling with is how to find employees laid off as far back as September. Also, the legislation says only workers who were ‘involuntarily terminated’ are eligible, but never defines that term. Does it include only people who are laid off? Or those who take buyouts offered by their employers? No one knows how many people will actually seek a share of the stimulus money to pay their COBRA premiums. Congressional experts estimated 7 million, but that may be too high. Advocates fear that even cut-rate COBRA could prove too little, too late for some jobless Americans. ‘For many people it will remain unaffordable,’ said Ron Pollack, executive director of Families USA, a liberal advocacy group that has worked for years to expand health care coverage.