Thanks to the many of you who’ve jumped into the conversation. Whatever your opinions about the health reform bill, you’ve said that you still need affordable options, and you want us to keep working on your behalf to bring them to freelancers. We hear you loud and clear, and we couldn’t agree more. To our members with FIC insurance plans: FIC will continue to offer plans to freelancers in New York, and plans to do so even after the Exchanges are in place in 2014. While health reform has passed, many details will need to be worked out. We will continue to make sure freelancers’ needs are included and will look to you to be involved in advocacy campaigns and make sure freelancers are actively shaping how reform plays out. Further, we are looking to bring you more affordable options in the coming year by innovating new models based on your feedback about what matters to you most. Following are our responses to your questions after my previous post. We’ve tried to spell out the most predictable changes you can anticipate as health reforms are put into practice, but everything is not happening at once—and some changes will not take place for several years. Many outcomes, like future costs, are unpredictable at this point. “Will we be dropped by Freelancers? Do you have a realistic time frame that these changes will take place? Our new policy year began in January, 2010. Is it realistic this plan will be changed drastically or dropped in this calendar year?” - Marguerite & Robert Fox No, you will not be dropped from the insurance group, nor will we change our plan offerings during the year. During the course of the year, we will be monitoring any changes to plan benefits resulting from health reform and will keep you posted. However, FIC is way ahead of the rest of the country in consumer protections in large part because we started in New York State, which is very progressive compared to almost any state. So while the legislation might require insurers to immediately make some changes to plans, those will mostly be changes which benefit the consumer, and these will mostly affect consumers outside of New York. “As a freelancer who is making more than $43K, I wonder what good any of the current legislation will do for my pocketbook?” – Marc Jacoby Legislators hope that many of the reforms will help drive down costs across the board, but these impacts are hard to predict. You will be able to purchase health insurance through an Exchange (it’s estimated that plans will cost $483 a month), but you will not be eligible for subsidies. Plans offered in an Exchange will have to meet certain minimum benefit requirements, like covering hospitalization, preventive care, and prescription drugs. (Note that “covered” does not mean 100% paid for by the insurer, – coverage includes cost-sharing features, meaning you may be responsible for some portion of the cost.) Your question also mentioned the way FIC used to cover certain procedures as surgery rather than part of the office visit—FIC changed this policy in its 2010 plans in response to member feedback. “Will my cost be reduced or copays go down? Also will yearly increases be less than in the past?” – Bernard FIC’s yearly approach to determining the costs of health insurance—from your monthly premium to the amount of your copay—is determined by the wider market, member feedback, and the way members in our group use their plans. We balance actuarial work against the needs of our members to design a sustainable range of plans, so our options will be around for freelancers next year and twenty years from now. FIC has been aggressive in keeping premium prices well below the rest of the market, while we all agree that health costs have gotten ridiculous, freelancers in new York State are already way ahead of the rest of the market. FIC’s premiums currently range from $196 to $497 per month, compared to standard individual health plans which start at $752 per month. “What happens to a person’s current rates if they are making less than $43,320? Are the monthly rates lowered? How will that work?” – Lucia Rossi In 2014, if you earn less than $14,404 (individual) or $29,326 (family of 4), you will be eligible for Medicaid. In 2014, if you earn between $14,404-$43,320 as an individual (or $29,326-$88,200 for a family of 4), you will be eligible for subsidies to purchase insurance and limit your out-of-pocket costs (copays, coinsurance, and deductibles). All subsidies will be on a sliding scale based on income. “Will this legislation help Freelancers Union be able to offer the insurance that you offer in NY to members living in other states?“ – Melissa This reform opens the field to new strategies and approaches. We will be working with other states and DC to expand our model to other states where many freelancers want the same coverage available in New York. But we’ll need members to help “educate” elected officials who are still behind the curve when it comes to freelancers’ needs. “Will we as individuals be able to shop for alternative plans as individuals? Beyond marketing Freelancers Union, help us become informed consumers and advocates!” – Sam Individuals will continue to have access to individual plans in the insurance marketplace, just as they do now. All plans in the Exchange will be individual plans, rather than group plans like those offered by FIC. Those plans, as well as FIC’s, will all meet the coverage minimums required by law. As you and several other members have pointed out, being an informed consumer is critical to controlling your own costs—and our job here is to get you the information you need. We will have new strategies in the next few months about how to navigate the health care system by using your insurance plan strategically. “I’d like to know more about the tax breaks for small businesses. Will this apply to those of us who file Schedule C and have no employees (other than ourselves)?” - Lynne Spevack Sole-proprietors are explicitly excluded from the small-business tax credits, but may be eligible for premium subsidies in 2014.