Health Insurance HQ: An Update on the Health Care Landscape

Welcome to Health Insurance HQ—coming to you from the experts at The Actors Fund’s Artists Health Insurance Resource Center and special guests!

Health Insurance HQ distills the current political activity around health care into a brief, monthly educational update to help you become a more active consumer and citizen. Our experts in the field and others in our community are here to provide you with plenty of handy resources to help you use your voice and your vote to make a difference. 

Dear Friends,

On March 6, House Republican leaders released a proposal to repeal and replace the Affordable Care Act. It outlined several areas of change; here are some key take-aways for our community:

  1. Repeal the individual mandate:  This would remove the requirement to have health insurance coverage.  There is concern that repealing this would lead to healthy people not purchasing insurance, which could ultimately lead to the collapse of the individual insurance market. In addition, the proposal would penalize those who don’t maintain continuous insurance coverage. If, for example, you lose your union coverage and are without insurance for 63 days, you would be charged 30% more for premiums for the next 12 months. This would have a seriousimpact on our community, since so many cycle on and off insurance throughout the year.
  2. Cap Medicaid funding: The proposal would keep in place the ACA’s Medicaid coverage for low-income adults (in 2016, anyone earning below $16,395/year) until 2020. After that, Medicaid funding would be drastically changed, and millions could lose coverage.  It would also put coverage for children, seniors, and people with disabilities and HIV/AIDS at risk. The new vision for Medicaid would offer states a lump sum to run the program, which would not change over time.  As health care costs rise, the funding pot would stay the same. States would be forced to decide who would lose coverage and how care would be rationed. Each year, the question would be: who, or what, gets thrown out of the lifeboat? 
  3.  Make health care tax credits less generous and less flexible: tax credits would not adjust based on  your income or the local cost of health coverage, as they do now, but based on your age. Someone who is 30 would receive $2000/year to offset the cost of coverage; at age 60, it would double to $4000/year. Currently, the ACA’s tax credits adjust automatically to provide some protection from premium increases. This new approach would not do that. In addition, it’s possible that the almost 700,000 people on the extremely popular Essential Plan in New York would lose their coverage. 
  4. Expand Health Savings Accounts:  HSAs — tax-advantaged accounts in which you can save money to pay out-of-pocket health expenses — are of little or no value to most of the people who would lose coverage under an ACA repeal.  They only work if you can afford to set aside income; not many in this industry have the disposable income to do that.  
  5.  Create “State Innovation Grants” to substitute for coverage: This seems to be a catch-all program with few details, aimed at those who would otherwise fall through the cracks. It reads a bit like a magic wand that can be waived to lower the cost of care for the most vulnerable patients. It suggests that “high risk pools” would be one way to cover these consumers. In the past, 35 states had high-risk pools, and they failed to provide affordable, quality coverage. The pools had extremely high premiums (often 1.5 - 2 times the market rate), high deductibles, and very limited benefits, including lifetime caps.  They also excluded pre-existing conditions for 6-12 months. 
  6. Charge older people more: older customers could be charged up to five times more than younger customers.

Under their proposal, the following important parts of the ACA would remain in place: pre-existing conditions would not be excluded; dependents up to age 26 could stay on their parents coverage; Insurers would have to offer 10 essential health benefits, including hospitalization, as part of every policy; and annual and lifetime maximums would be prohibited.

Since 2010, approximately 20 million Americans have obtained coverage—in all ethnic groups in every region of the country, including nearly 3 million children.  Replacing the ACA with the above proposal gives big tax breaks to the wealthy, while endangering the health and financial stability of millions of Americans.  Although far from perfect, Obamacare has done a lot of good.  It provides more affordable, comprehensive health insurance than what was available before.  

So what can you do? Check out last month’s HQ post on how to get involved. Time is of the essence, as House leaders have indicated they want to fast-track this proposal, with the goal of replacing the ACA by the first week of April. However, the House does not yet have the votes it needs to pass a bill, so there is still a strong opportunity to influence this process. Call, write, email, or tweet to the House Members on the Energy & Commerce and Ways & Means committees. This is an important moment and you can help shape the future of the health care landscape.

Yours in good health,

Renata Marinaro
National Director of Health Services at The Actors Fund

P.S. Do you work in performing arts and entertainment and have questions about health insurance? We provide assistance nationally. Contact my team at our regional office closest to you to speak to a counselor.

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Don’t forget to use the resources section of our website. It contains tools to help you make decisions about your health insurance, including new online tutorials on how to choose providers and how to read an Explanation of Benefits. In addition, you’ll find an updated Stage Managers National Health Directory, our national online directory of healthcare providers recommended by industry professionals that can be used by theatres and touring companies. For these resources and more, visit You can also find out more about enrollment assistance and upcoming health insurance seminars near you!