Editor note: I received this article from Michael a while back and have been in a bit of turmoil about it. The subject is a contentious one, and different views, stories, and perspectives abound. I almost didn’t publish it. But, since I am all about education, and the crux of this article speaks to educating yourself as a photographer about the issue of medical insurance in your profession, decided to approve it. Some of this I agree with, some I do not. I personally think that the ACA is ultimately legislation designed at controlling the population, and really has very little to do with healthcare. That being said, judge for yourself, and thanks to Michael for his thoughts here…
Health insurance could be called the silver bullet in the life of the freelance photographer. When all seems to be going swimmingly and work is in abundance, you remember this one thorn in your side. The Affordable Care Act (ACA) looks to be making some big changes to the system. Some of these changes stand to benefit freelancers, while others may have a negative impact. To learn about this sweeping piece legislation and how it will affect you, read on.
Ten Benefits For Every Plan
The essential health benefits are ten categories of medical benefits that under the ACA every single health insurance plan out there will need to cover. Whether the premium is two or five thousand, they will have the benefits listed here. The benefits have names like ‘preventive services’ and ‘maternity care’, but the individual medical services that fall under these broad titles aren’t actually defined by the ACA.
Instead the federal government opted to let each state decide what the essential benefits within its borders will be. This decision has an up and a downside of course. It allowed states to lean towards specific medical treatments that their residents want or need, but on the other hand this decision has created significant disparities in the level of mandated medical care among states under the ACA.
The Individual Mandate
The individual mandate, that everyone by law has to have health insurance, is a controversial aspect of the ACA. If you do not have health insurance, you will be charged a penalty. The penalty per person starts out at $95 or 1% of your income in 2014, goes up to $325 or 2% of your income in 2015 and rises yet again to $695 or 2.5% of your income in 2016. In the years following that the penalty will be tied to inflation or it will be 2.5% of your income.
The penalty is designed to be any higher than the national average of the annual premium of a bronze plan on the marketplace. Given this, it seems clearly designed to make it more cost effective to have a cheap insurance plan than no insurance at all.
This part of the ACA certainly raises questions though. While the Supreme Court upheld the constitutionality of the individual mandate, that doesn’t make it just. It takes a certain amount of autonomy away from citizens. For those who are already covered, this may not be a big deal, but for people who have been getting by on good health and good luck, this could be a frustrating part of the ACA.
Ask Yourself A Few Questions
Hearing about the essential health benefits may have warmed you up to looking at a plan, even if the individual mandate is not your cup of tea. When choosing a plan you’ve got to know before-hand what you are looking for. What is the absolute most you can realistically spend on healthcare? What is the amount of money that you would rather not go over? Be honest. Things like pre-existing condition, number of family members and more can make a big difference in the cost that you can expect to pay. Sometime you just can’t beat old fashioned pen and paper for brainstorming.
Start Looking At Plans
For residents of most states the currently dreaded and glitchy, federal exchange at Healthcare.gov will be the place to go for purchasing health insurance under the ACA. Some states are running their own exchange, and you can find out if your state is one of those by looking at the the Kaiser Family Foundation’s list here.
All the exchanges plans are named according to the cost of their premiums and the amount of coverage they are going to give you. Platinum gives you the highest premiums and the most coverage, and bronze the lowest. Silver and gold plans fit into a space in between those two, rounding out your options.
Of course you’re not required to purchase a health insurance plan only at the exchanges. There are a number of big name insurance companies selling plans off the exchanges. The big attraction for exchange plans are the built in tax credits (described below) for those with qualifying incomes. If you make too much money for a tax credit it might be a good idea to look off the exchange to satisfy your health insurance needs.
Find Out If You Can Save
If none of that piqued your interest, this should: tax credits. People who make between 100 percent and 400 percent of the Federal Poverty Line can get a hefty tax credit on their health insurance plan purchased at the exchange. The actual amount of your tax credit depends on a pretty wide range of things, your income being only one part of it. The Kaiser Family Foundation’s subsidy calculator should help you determine a ballpark figure for budgeting purposes.
There is an unfortunate flip side to this. What if your annual income is more than 400 percent of the Federal Poverty Line? Some people have reported that premiums for their current health insurance have risen significantly, or their plans are being cancelled outright because they don’t meet the new standards of the ACA. In cases like this it’s worth investigating what sort of health insurance offerings are available to you off of the exchange.
While the ACA came with the promise of affordable healthcare for all, things don’t seem to be panning out so perfectly. For some, things will get better and for many others it will be worse. That being said though, it is a fact of life (for the moment at least) and hopefully you’re feeling more informed and confident about the law. However, don’t stop learning about the ACA now. Keep getting all the information you can about it. You might even consider talking with a licensed insurance broker. They are a great help when it comes to picking a plan. With all that, you should be starting to feel prepared so you can go out there and take action.
Michael Cahill is the Editor of the Vista Health Solutions Blog. He writes about the health care system, health insurance industry and the Affordable Care Act. Follow him on Twitter at @VistaHealthMike