In October as the program was being rolled out across the country, a group of freelance artists, developers, writers and etc. gathered in the foyer of Capitol Hill’s Office Nomads to learn what the Affordable Care Act will mean for the growing ranks of independent workers.
“This is supposed to be about improving health, not just about having a card in our pocket,” said James Whitfield, president of the nonprofit Washington Health Foundation, who was on hand to walk the group through the basics of getting covered in the Obamacare era. “Ultimately, the only thing that makes this cheaper is for us to become healthier.”
The gathering at Nomads, one of three coworking spaces on the Hill, included engineers, graphic designers, and others toting degrees and technical knowledge — not the Tea Party’s stereotypical group of uninsured or under-insured workers, but perhaps increasingly becoming the norm. (Full disclosure: CHS in a Nomads member.)
According to Whitfield, the core takeaway for independents is new insurance plans will be more expensive, more comprehensive, and slightly more confusing. But for those who have powered through sickness and relied on walk-in clinics, getting mandatory insurance will ideally mean more healthy living.
It’s difficult to deny that the model of employer-based health insurance is rapidly losing relevance for many workers and families.
As the March 2014 individual mandate deadline looms, Capitol Hill’s thousands of freelancers, independent contractors, and small business owners face some baffling decisions. Glitches aside, the Washington Health Benefits Exchange is proving to be a hard nut to crack for the boss-less class.
Among the biggest positives for indie workers is the new law’s protections for those with preexisting conditions. Under the previous system it was much easier for those covered by individual plans to get dropped or barred by insurance companies for preexisting illnesses, now a thing of the past.
The state exchange, which is reportedly running smoothly in Washington as more than 60,000 residents of the estimated 1 million uninsured in the state were enrolled in the first two weeks of the program, streamlines the insurance shopping experience for those who don’t have a HR department to do it for them. Those new plans must also cover ten essential health benefits, including lots of preventative care. When paid sick days aren’t a luxury, preventative care can be a self-employed worker’s best friend.
Fischer Qua, also from the Health Foundation, said part of the nonprofit’s mission is to ensure that those thinking about moving off their employer’s insurance and into individual plans get the best coverage possible.
“Our biggest concern is that we want to make that transition safe for people,” Qua said.
In Washington, small business owners and independents face a handful of unique challenges. While the state created a health exchange for individuals, the state exchange and health insurers failed to create a similar service for small businesses.
The small business exchange, known as SHOP, was supposed to be part of the Washington state exchange roll-out. Whitfield said its a problem for small and independent businesses because they cannot easily compare group plans to individual plans.
Adding to the confusion is a bizarre coverage glitch that could mean more headaches for indies. If your spouse is offered insurance at their job, you are ineligible for expanded Medicaid coverage or insurance tax exemptions, even if your spouse’s plan does not extend to you.
Whitfield said he has advised some of his small business clients to actually forgo offering health insurance that would not have extended to spouses so their families can maintain eligibility for tax credits.
Outside of Washington, a few states are moving forward with coop insurance models. Among the most promising is the Freelancers Union, which is setting up group health insurance plans for independent workers in Oregon, New York, and New Jersey.
While increasing numbers of workers going the independent route, Whitfield said it’s not for a lack of contribution to the economy or society — those retiring today are almost assuredly getting a better deal than those who still have 20 to 30 years of work.
“Anyone who says young people aren’t doing their fair part for the country doesn’t understand what’s going on,” he said.