Unless you’ve been living under a rock, as the saying goes, you’ve heard about the recent efforts to repeal and replace the Affordable Care Act. Amid the political arguments and policy discussions, I have heard little or nothing about the effect of the insurance system on people in the creative professions, especially the many of us who are self-employed. It may surprise some people to learn that a poorly managed health-care system could severely hinder progress in the arts.
Like most Americans, artists and other creative types need to provide for themselves and their dependents in a country where going without insurance could be ruinous. If health insurance isn’t affordable, a lot of creative entrepreneurs are likely to put their own work aside and take other kinds of jobs, simply to get access to coverage.
My own situation is an example. After working for various employers in the legal profession, I decided to strike out on my own to become a full-time photographer and visual artist. I operate through an LLC, but it’s essentially a freelance business, with all the excitement and unpredictability that entails. Moreover, I have a wife and two young children, who create an acute need for health insurance (I love them anyway). As part of our plan for child-rearing, my wife and I decided years ago that she would not work outside the home, at least while the kids were young.
Without access to group insurance through an employer, I had to figure out how to obtain coverage. The cost of insurance on the open market was prohibitive, especially for someone in the formative stages of a new business. This led me to the government marketplace, where the tax credits made things much more affordable. Notably, although the premiums were manageable, the marketplace plans had far higher deductibles and out-of-pocket limits than the policies that I had as an employee. Nonetheless, the system made it feasible for me to provide coverage for myself and my family.
I don’t intend to talk politics here, and I will readily concede that there may be better ways than the Affordable Care Act to regulate the system. But in light of all this, you can understand why I might get nervous when politicians talk about relaxing essential coverage requirements, or freeing insurers to charge more based on age or preexisting conditions (which are present in my family). Without affordable access to meaningful coverage, many people will be deterred from striking out on their own because of their need to insure themselves and their dependents.
I realize that there are worse things in life than having to work for someone else in order to get by. And yet we live in a fabulously wealthy society, at a point in history when we need creativity and entrepreneurship as much as we ever have. Whatever direction the laws take, we should do everything we can to avoid erecting barriers to the kind of enterprise that will advance the arts and other parts of our society. Without affordable health care, entrepreneurship in creative fields – or, indeed, in any fields – will be jeopardized, and America will be the worse for it.