Health Insurance HQ: An Update on the Health Care Landscape | Actors Fund

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,

Dear Friends, Open Enrollment has begun, and we're hearing from people who are anxious, frustrated and confused. With all of the switchbacks in the national health care discussion recently, that's understandable. It's hard to know what's accurate and who to trust. Let me dispel a couple myths:

Myth #1: The Affordable Care Act (ACA) is dead.

The ACA is not dead; it was not repealed and is still the law of the land. In fact, all of the provisions in the ACA, including the prohibition against discrimination based on gender or pre-existing condition, are still in place. There are still penalties for being uninsured (2.5% of your income, or $695 per person, whichever is greater).

Myth#2: You have to enroll before December 15.

This isn't really a myth – it's true in many states. In all the states that use the federal marketplace, or exchange, the deadline to enroll is December 15. However, in New York and California, the deadline is January 31, 2018. To find the deadline in your state, visit our health insurance HQ from last month.

Myth #3: You can't get premium tax credits anymore.

Premium tax credits, which lower the cost of your monthly premiums, are still available to anyone making less than 400% of the Federal Poverty Level. For an individual in the lower 48 states, that equates to less than roughly $47,000 per year. In fact, they've been made more robust this year, to keep up with large increases in premiums.

Myth #4: You can't get cost sharing reductions anymore.

Some people who make between approximately $16,000 and $29,000 per year (for an individual) are able to get plans that have lower-than-normal deductibles and co-pays; this is a form of financial assistance called "cost sharing reduction", or CSR. These cost sharing reductions are still in place, meaning people at this income level can still get plans with lower deductibles and co-pays. President Trump simply decided not to fund them anymore, but since they are mandated by law, insurers have to foot the bill.

Myth #5: You can't get help enrolling.

Although the current administration has taken steps to undermine the ACA, including gutting marketing, outreach, and budgets that support enrollment assisters, you can still get help enrolling. The Artists Health Insurance Resource Center is here to help everyone in our community nationwide understand their options and enroll in insurance. Visit our Open Enrollment page to find a seminar near you, or to book an appointment with an enrollment assister. If you live outside the Los Angeles or New York City area (or have friends who do), please be aware that we offer phone consultations and online tutorials.

Myth #6: Plans and prices could change at any time.

You don't have to worry about your prices changing mid-year; prices for 2018 are now final, and  insurers can no longer pull out of the market.

Now that we've cleared up some of the misinformation that's out there, let's talk about what to expect for this Open Enrollment period. The experience of shopping for insurance will vary greatly from state to state. New York and California still have robust exchanges, despite the exit of several insurers, including Anthem Blue Cross, Affinity, and Care Connect. However, in many other states, the choices are limited. Nearly half of all counties will find just a single insurer selling plans.

Prices have also gone up. In addition to regular rate hikes, silver level plans bear an additional surcharge to make up for the loss of federal funding for the cost sharing subsidies. However, "Covered California estimates that 78% of subsidized consumers will pay the same as - or less than - this year, despite the surcharge, because their tax credits will rise with their premiums." Although New York's State of Health Exchange did not release numbers, they also estimated that in many cases consumers costs would be the same or lower this year.

If you're someone who doesn't get a subsidy, you have to be the most careful shopper of all. Middle-class enrollees will be hit the hardest. Because insurers shifted costs to silver level plans, consumers may find a better deal at the gold level - which is good news, since gold plans generally have lower deductibles. According to the Kaiser Family Foundation, a non-profit which focuses on national health issues, in states "where only silver premiums are increasing, [consumers] can avoid paying a surcharge by enrolling in a bronze or gold plan. And, where only silver premiums inside the marketplace are increasing, they can avoid paying more by enrolling in a bronze or gold marketplace plan, or any type of plan outside the marketplace." Plans outside the marketplace can be bought directly from insurance companies.

Bottom line: this year, it's more important than ever to shop around for coverage.

Yours in good health,


Renata Marinaro
National Director of Health Services at The Actors Fund

Do you work in performing arts and entertainment and have questions about health insurance? The Actors Fund provides assistance nationally. Contact our regional office closest to you to speak to a counselor.

New York City
917.281.5975

Los Angeles
855.491.3357

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 health care providers recommended by industry professionals that can be used by theatres and touring companies. For these resources and more, visit actorsfund.org/HealthServices. You can also find out more about enrollment assistance and upcoming health insurance seminars near you!

Photo © Kimberly M. Wang / eardog.com