Independence may be the big perk of freelance writing or starting a new media venture, but when it comes to finding affordable health insurance, that perk can become a real problem.
Last fall, with the goal of saving members money on health insurance, NASW joined a collaborative committee of about a dozen writing and publishing associations to explore alternatives to health insurance plans offered through the Affordable Care Act marketplace. The catalyst for forming this exploratory committee was a 2018 policy from the Trump Administration that allows more small businesses to join forces to obtain group health coverage. Our hope was that together with book industry colleagues such as the Authors Guild, Graphic Artists Guild, and American Booksellers Association, NASW might reach the numbers necessary to be eligible to create one of these new types of group health insurance plans.
Carmen Drahl, an NASW freelancer based in Washington, D.C., acted as NASW’s representative to the committee. Meanwhile, NASW members answered an anonymous survey designed to estimate how much of the membership would be interested in group health insurance and to probe what those members would want their coverage to look like.
Through the survey results, we learned about the state of health coverage for our members. We made the assumption that the members who would be most likely to purchase group insurance through NASW are freelancers who pay the full cost of a policy because they aren’t covered by a partner’s health plan. We therefore focused on that subset of responses and extrapolated them to reflect NASW’s freelance membership. The results suggested that about 250 freelance members would be interested in group health insurance. About 225 freelance members were not satisfied with their current health insurance, and when we probed the reasons for dissatisfaction, it appeared to be due to annual premiums of $5,000 or more ($417/month) or an annual deductible of $2,500 or more. Members who were not satisfied with their coverage tended to identify as female (after adjusting for the fact that most survey-takers identified as female), and were between the ages of 45 and 64 (after adjusting for survey-takers’ ages).
Armed with the survey information from NASW and its sister societies, the multi-association committee entered into discussions with consultants and insurance brokers to determine whether group coverage would be feasible. Here’s why NASW can’t help with group coverage:
• A health plan that costs less than the Affordable Care Act plans but carries all the same benefits and protections does not exist. (It’s worth noting that the average monthly Affordable Care Act plan premium for a 40-year-old individual is $477, above the dissatisfaction threshold in NASW’s survey.)
• The newly permitted group health plans are not available to sole proprietor businesses and single-member LLCs, which make up the majority of NASW’s freelance membership. The new group health plans are meant for collections of businesses with a few employees, such as a group of small bookshops.
• Moreover, for sole proprietors and single-member LLC’s, coverage options outside of Affordable Care Act plans are limited. Such plans would require compromises in exchange for a chance at lower monthly premiums, such as limitations on pre-existing conditions, or a cap on how much the insurance company will pay for your care over your lifetime. Some states, including New York and California, prohibit these types of plans.
It’s an unsatisfying conclusion to what started out as a hopeful possibility, but based on our research, at this time there is no viable group health insurance for our members that does as good a job as or a better job than Affordable Care Act plans at a cheaper price. With that said, health insurance is at the forefront of 2020 election issues, so we will continue to watch the space and keep members informed about how changes in the law might bring new benefits.
