Health care for freelancers: Is pursuit of happiness a pre-existing condition?

Health care for freelancers could open up the arts worldIn the second of two parts, Dollar-Store Dilettante columnist Steven Kent continues to explore health care reform as it relates to recent college graduates struggling in the employment market, often tackling several part-time jobs.Read Part one by clicking the link: "In health care reform, where's the heart for artists?"

A few months after I graduated college in May of 2009 with a degree in journalism, I briefly considered making a run at becoming a full-time writer, at least for the six months' grace period until my student loans came due. All I had under my belt at the time was the part-time barista position that had pushed me through college anyway, and I imagined writing as a great way to build my portfolio and, maybe more importantly, give me a real sense of a working life in the profession I had signed up for.

My pie-in-the-sky plans ground to a screeching halt, though, when I considered the issue of health care. I realized that, at age 25, my parents' insurance wouldn't cover me even if I lived at home. When I looked up coverage through an online market, I thought I might -- might -- be able to scrape up the monthly cash for one of the high-deductible, bare-bones plans advertised for $120 per month. That hope shattered when the insurance company learned of some prior battles I had with panic attacks and depression, and of my occasional tobacco use (which I've since quit), and inflated their original quote well over $400 per month. (And I thought the idea of health insurance was to ... uhm ... care for people with health issues.)

If you followed the first part of my two-part examination of President Obama's new health care bill and its implications for American artists, musicians and writers, you probably understand that, for the notoriously nomadic and often self-employed arts community, quality health insurance can become a kind of wild orchid -- an object so rare and mercurial that one could spend a lifetime chasing after it.

However, you might still find yourself surprised -- much like I was when I tried to purchase my own health insurance last year -- by some of the challenges the uninsured face, and how the new bill might change the dynamics of the way they (or you) acquire health insurance. Read on to learn more about how the new law could further affect artists and students of the arts in the not-too-distant future.

Pre-existing conditions (of all shapes and sizes)

There's been a lot of talk in the media about the the provision in the bill that requires insurance providers to cover people with pre-existing conditions. Effectively, if you've already got a chronic illness or ailment, no one can flat-out deny you health coverage under the new law -- to which most college students who've never tried to purchase insurance would most likely respond, "Who cares? I'm 22 and I don't have cancer."

However, hopefully you paid attention to my account of shopping for individual health coverage and realized that "pre-existing conditions" can (and do) include things that often beset normal, healthy college kids: asthma, diabetes, allergies, depression, eating disorders and countless others. Up to this point, you could quite literally get denied private coverage for suffering from hay fever. As a result, for the self-employed artist with a pre-existing condition, the battle to get coverage could stretch over a lifetime, but the new bill should change that sad fact.

This rule won't take full effect until 2014, when the mandate for individuals kicks in and (ideally) spreads the risk of insuring those with pre-existing conditions over the general influx of healthy people who get forced to buy coverage. Whether this will actually make health care more affordable, or just jack up the premiums for healthy people as well the sick, remains a matter of heated debate that might not reach a conclusion for years. But, at the very least, the bill provides some assurance that these pre-existing conditions will no longer make it impossible for an individual to acquire health insurance.

Health insurance for non-profits, too

When I spoke to Narric Rome, Director of Federal Affairs at Americans For The Arts, about the health care bill, he surprised me when I asked him what part of the bill held the most value for the arts community.

"For us, it's definitely the tax credits for non-profits that we're most excited about," he said. "Are you familiar with that part of the bill?"

My poised response, while scrambling through my chicken-scratch research notes: "Sure. Wait. Huh?"

Turns out I'm not probably not the only one who missed that point. Not only did none of the publications I perused in my research mention anything about this part of the bill, but the Huffington Post recently pointed it out as one of the most under-discussed aspects of the new law.

Basically, small businesses can now apply for tax credits to help subsidize the cost of health insurance if they provide coverage for their employees. This wouldn't seem like much help for small non-profit organizations, where Rome said that many artists find work, since many of them enjoy tax-exempt status. In order to equalize the benefits for businesses and non-profits, though, the final bill allows non-profit organizations to apply the credits to certain payroll taxes, like the money they withhold from employee checks for Medicare.

"That right there, that provision is active right now," Rome said. "And it could mean a great deal to the arts by making art-based non-profit organizations a viable full-time employment opportunity, offering competitive health benefits."

What does it all mean for the arts and freelancers?

When House Speaker Nancy Pelosi recently claimed that health care reform would allow artists to focus on their professions full-time, some conservative commentators offered a predictably canned response. One cynic over at the Washington Examiner wrote that for pro-reform progressives, "the mediocre melodies of their street-bard children will be cold comfort indeed when they're warming their hands over hobo-fires in Haight-Ashbury." (Wait: They forgot the pot smoking and tie-dye underwear.)

Such cartoonish reductionism tries to smoke-screen the fact that, for example, career musicians whose work you can purchase in record stores across the nation -- artists such as Kimya Dawson of the Moldy Peaches and Franz Nicolay of Hold Steady fame, whose work means a great deal to myself and others -- still struggle through much of their (successful!) careers to acquire and maintain health insurance.

Sure, it's tolerable to toil away at a day job in service of your dream career if you're a recent college grad like me. But I've slaved over the espresso bar alongside a 53-year-old father of two who found himself in the same situation. That co-worker, an accomplished and in-demand professional photographer with 20 years of experience, couldn't find any other way to obtain affordable health insurance for himself and his family due to -- yes -- a pre-existing condition.

Whether or not President Obama's health care bill will create meaningful change for the arts community will take time to figure out. But if the new law frees creative professionals like my co-worker, and millions of other working artists, writers and musicians, from the chronic burden of underinsurance and allows them to concentrate on their work with both passion and peace of mind, history may look back on it as the first step toward a culture that values both art and the artists whose visions gave it life.

Steven Kent is the Dollar Store Dilettante, a blasé lad who knows more about saving a buck and stoking his hipster credentials than all his editors combined. His Money College column runs Sundays; send tips and best MP3s of Pitchfork bands to Steven at
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