If that is so, what impact will it make on members of the performing arts profession?
Joseph P. Benincasa, president and CEO of the Actors Fund, had no doubts about the effect. On the day of the decision—which stunned many who thought the conservative-leaning court would strike down the Obama administration's signature, and most controversial, piece of lawmaking—he issued a press release saying, “Today’s Supreme Court decision to uphold the Affordable Care Act is good news for all artists."
Certainly, actors and other theatre professionals are among the most chronically underemployed and uninsured workers in the United States. Any little bit of outside assistance helps in sustaining a life in the arts. And, according to Jim Brown, National Director of Health Services at the Actors Fund, the ACA will offer more than a little bit.
"It's as if it's written for people in our industry!" he said of the ACA.
Across the nation, between 60 and 70 percent get their insurance through their place of employment, Brown explained. Another 20 percent receive insurance through Medicare and Medicaid. That leaves something like ten to 15 percent who are left to their own devices in the individual health-care market.
Double that figure and you get a rough estimate of the number of actors and other theatre workers who are uninsured.
"We've been working for this for a long time," said Brown. "The Actors Fund has had an artists insurance resource center since 1998. We have a free clinic as well. The number of people uninsured in entertainment and performing arts is tremendous. It's been estimated at twice that found in the general population, so it's at about 30-32 percent are uninsured."
Actors can get affordable insurance through their unions, but only after having worked a certain number of weeks a year. If, as is the case with many union members, they don't meet that criterion, they have to fend for themselves. The least-expensive HMO currently available in New York City, said Brown, comes from HIP. It costs a whopping $920 a month. As for those who attain union insurance, but then lose it when they fall into unemployment, they can take advantage of COBRA to hold on to their benefits, but at a cost of $600 or $700 a month.
The Affordable Care Act will alter this situation by giving actors more options and making health insurance more affordable.
"That's what ACA does," said Brown. "It reforms that market, it changes that market. That alone is a help and is tremendously significant for people in our industry. They're out there in the market trying to buy health insurance and that's a very expensive market."
The federal program will benefit actors in a variety of ways. In the most basic respect, insurance seekers will no longer be on their own. "The ACA allows the individual to be in the small group market," explained Brown. "They get the benefits of being part of a group. The law will by 2014 set up something called Exchanges, which are competitive marketplaces. These Exchanges will be multi-state. They'll be able to pick a plan from these Exchanges. Private insurers will compete. More people will buy it—people who couldn't afford it before—because their premiums will be subsidized."
Under Federal law, the official poverty level is currently just over $11,000 a year. Brown said he deals with a lot of theatre people who make between $25,000 and $45,000 a year. Under the ACA, people making under 400% of Federal poverty level—under $44,000—will now qualify for insurance premiums that are subsidized through tax credits, lower premiums and lower out-of-pocket costs. Also, "No one will be forced to pay more than eight percent of their income in health insurance," added Brown. "Essentially, they're defining what affordable health care is. It's why it's called the Affordable Care Act. It's really about the cost of insurance and bringing that cost down." The law will also adjust the level at which suffering workers can qualify for Medicaid—something that will help actors get through a rough patch.
"We have people in this industry who have a bad year and their income drops precipitously," explained Brown. "Some of these people will now be eligible for Medicaid, because the law raises the eligibility for Medicaid around the country to 133% of the Federal poverty level. This is a huge change. In New York right now, your income would have to be below 78% of the Federal poverty level. You'd have to be really making about $8,500 a year. This will bring up the income level. This will be around the country, and it'll include actors who, because of the episodic nature of their work, have a bad year."
Young people—in many ways the backbone of the theatre world, because they represent the future of the art—will, in particular, profit from the advent at the ACA.
"In the performing arts we have a lot of younger people," said Brown. "The industry is heavily weighted toward that. That's when people see if they can make a living in it. The mandate is terrific for those people, because otherwise a lot of them don't usually buy insurance. They see themselves as healthy or invincible. It's not uncommon at the Actors Fund that we see someone who's young who's uninsured and now suddenly has a bill of $80,000 because of an accident or a week in the hospital."
Additionally, there is the proviso that will allow young actors to remain on their parents' health insurance plan until they are 26. "This is huge," said Brown. "It's just tremendous. This really permits them to not take that risk. You're just another child on your family's insurance. You don't have to live with your folks, you can be independent, and still be on their insurance."
People under 30 will also be allowed to buy what is known as catastrophic health insurance, which will protect them against financially ruinous health bills.
The ACA will not just alter the lives of individuals. It is already changing the way small performing arts businesses conduct their affairs. "From the day the law was set in March 2010, there's been a subsidy for small businesses with fewer than 25 employees where the average income is less than $50,000," said Brown. "If the company pays 50 percent of the health care of the people who work there, then the government will pay 35 percent for a for-profit company. For a nonprofit, it's 25 percent. In 2014, it becomes 35 percent for a nonprofit and 50 percent for for-profit."
This is significant, since many people in the theatre industry work for small businesses, be they small theatres, video production companies, bands or dance organizations. Brown knows of a number of such outfits who are currently looking into insuring their employees. "It's been impossible before this. This subsidy puts it within their reach." (Under the ACA, only large companies of more than 50 people are mandated to offer insurance to their people.)
The Actors Fund is doing its utmost to get the word out about the ACA and help theatre professionals understand how they stand to benefit. "Every Artist Insured," an explanatory 12-page booklet, can be found on the Actors Fund website. And, the Fund is giving seminars all around the country.
"In my view, the Democrats have done a bad job of explaining what this is about," said Brown. "When people find out the details, they'll like it."