I am a freelance journalist who
purchases his own insurance lost his insurance under the Affordable Care Act—formerly part of what folks in the insurance business call the individual market. You’ve likely heard a lot of talk about individual insurance in the last few weeks. Millions of Americans who purchased individual insurance in years past have lost their coverage in recent weeks because their old plans did not meet the Affordable Care Act’s stringent requirements.
Many self-employed individuals carry what is unofficially called “catastrophic insurance.” This is relatively inexpensive insurance in which the customer agrees to cover a goodly portion of medical costs up to a certain point (let’s say $3,500), after which the insurance company picks up the rest. That’s where the word catastrophic comes in. For minor maladies, the financial burden falls on the individual. For major illness, the insurance companies are on the hook.
President Obama doesn’t like catastrophic insurance plans. He calls them “substandard.”
I know it’s unfashionable, but I am going to stick up for the insurance industry on this one. It has much to be criticized for, but catastrophic insurance is something that it does quite well.
Those “substandard” catastrophic plans help make possible my profession—freelance writing. Before I was married and my wife and I took out a new policy, I generally paid anywhere from $75 to $150 a month for catastrophic care that also covered some doctor visits and co-pays. I paid for some costs out of pocket, but I didn’t mind, because I had peace of mind knowing that if the dreaded “hit by a bus” scenario ever came to pass, I’d be covered.
Those plans are no longer available under the Affordable Care Act. They are being regulated out of existence and replaced with plans that are more expensive and have higher deductibles because, as mandated by federal law, they must offer more coverage and cover those with preexisting conditions.
For individuals who work for themselves and who buy their own health coverage, our options are now severely limited. We cannot even choose—as I did for a year, without lasting consequence—to forego medical insurance without incurring a financial penalty.
It’s not hard to see how the Affordable Care Act could have an adverse effect on a host of self-employed professionals, including freelance journalists.
In my experience, freelance writers—the ones who succeed at it for years or decades—are bright, motivated individuals who could have pursued careers in academia, law, marketing or other more stable, higher-paying fields. They choose to freelance, in so many cases, because it affords them a desirable lifestyle.
But it’s a fragile life, that of a freelance writer, especially one with a family in which there is no spouse generously subsidizing family income and health care. I suspect this goes for all self-employed individuals. It takes confidence, persistence, talent and outside resources, such as day care/babysitters, a supportive spouse, and, yes, affordable health insurance.
Self-employment can be both grueling and unsteady work—work that seldom makes anyone rich. When the negatives outweigh the rewards, full-time employment, with its promise of a steady paycheck and health coverage, becomes more attractive.
What happens when an increasing number of talented freelance writers, spurred by higher or unsustainable health care costs, flee to the calming shores of teaching, academia, government, marketing, public relations, law and other professions? It certainly does not improve the state of journalism in this country. It adds to the journalism brain drain, one that already occurs naturally. Ask anyone who graduated from a J-school more than 10-15 years ago how many of their peers are still in the journalism game. An honest head count can be rather shocking.
The ACA will have winners and losers. With their health care options decreasing, health care costs rising and already thin family budgets being stretched even thinner, self-employed individuals and freelance journalists who do not have preexisting health conditions do not appear to be among those who benefit.
I’m not a pessimist by nature. I’d very much like to believe the ACA will somehow improve the lot of self-employed, middle-class individuals who take risks and try to make their dreams a reality. Let us not forget: the president promised affordable care and a better health care system for the entire nation, not just for some. I would like to be an optimist on this issue, and I have an open mind. Convince me.
More writing about journalism: