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Live@DC Policy Day: Health Care Reform and Its Impact on Musicians

Tuesday, May 25, 2010
by  presnikoff

#FMC10

Live event coverage.  Live stream transmission.

Second topic: Health Care Reform and its Impact on Musicians

 

 

Primer: A 2010 Future of Music Coalition survey found that 34 percent of the 1,400 musicians surveyed didn't have health insurance — twice the national average. Congress has succeeded in passing a health care reform bill, but what does it mean for “real musicians” — namely, those artists and songwriters trying to make a living in a time of unprecedented economic challenge? What will the bill do to expand coverage for the creative class, and what do musicians and their advocates need to know to take advantage of new opportunities? Advocates for musicians and health insurance will join with health policy experts to discuss key elements of this landmark legislation and how they will affect musicians and songwriters.





Kristin Thomson: Survey in 2002, 2,700 respondents, large percentage uninsured.  More recently, 33 percent [or 34 per above] said uninsured (twice the national average).  More detailed questions on what types of musicians uninsured, why, etc.

Found that more time spent on music, more likely to be uninsured.  Many are trying to create a career as a musician, part-time with another job.  Access to benefits from an employer often come from full-time access.

Cost clearly a factor - often primary factor.  Sometimes, costs mask lack of understanding over affordable options - state-funded plans, group plans, etc.

 

Renata Marinaro: [background on current health care legislation].

Social worker, works for actor's fund.  Dancers, singers, ushers, stage hands.  Various different types of services, financial assistant, housing, help training people to do sideline jobs, health care services.  'Seen how health care works and how it doesn't work,' and will address how health care reform will help the music industry, by 2014. 

A one-hour presentation in 15 minutes!  Focus is on how this reform legislation affects musicians, small business owners, etc.  Disclaimer, parts of this bill are ambiguous, and still being written.

[Rolls through various timetable changes through 2014, using PPT slides, images coming (refresh soon)]

 

Kristin Thomson: Pelosi comment, can artists quit their day jobs?

Adam Huttler: Not quite yet.  His organization offers health care programs to musicians.  Programs are getting phased in.  In terms of organizational offerings, NY strongest state.  Outside of NY, more of an advisor, steering people to plans that suit their different needs.  An advocate through that process.  Relationships with outside orgs., etc., including outside partnership w/ Aetna.  Constantly working to expand, not quite sure how the current medical changes will affect his group.

Alex Maiolo: Helping artists navigate health care - HINT - Health Navigation Tool.  Artists often 'have more options than they thought they had.'  A lot of artists who thought they couldn't get health care aren't aware of cheaper options.  As legislation rolls out, HINT will be based more on education.   Now, everyone has to get insurance, so their role is more oriented towards 'what does all of this mean'.

Kristin Thomson:  Best outcomes looking ahead?

Marinaro: Those not insured get the best gain here.  Costs could still be an issue, 'quite a chunk of change' still for many.

Kristin Thomson:  How can artists navigate these exchanges?

Marinaro: Not sure.  Rollouts happening now, programs supposed to be happening by June (like, next week June).   Currently health.gov site is 'good, but kind of propoganda,' but more details probably not until July.

Kristin Thomson: Membership in various orgs has been helpful in the past. Looking forward?

Adam Huttler: Issues of 'adverse selection,' that is why org-based plans are often problematic for providers.  Looking ahead, orgs may be 'more attractive,' valuable roles that a 'competent intermediary' could play. 

Fractured may be a 'navigator' for groups needing to find plans, not sure if there is a role for an 'industry-specific' navigator.  It would be 'a great idea,' but can 'the powers that be' be persuaded.

Alex Maiolo: More opportunities will exist for groups - like PROs - to get involved in this sort of thing. 

Kristin Thomson: Working bands incorporating as a small business?  Option?

Alex Maiolo: Potential option, though legally, cannot advise group to form an LLC just for health care.  Again, 'it remains to be seen,' 'not entirely sure of what the future holds' though 'plenty of space for bands considering incorporating'.

Marinaro: Major opportunity for people to advocate for what they want.  'Believe me' insurance groups are lobbying for what they want on the Hill, the process and uncertainty is opportunity.

Alex Maiolo: 'We're not becoming communists next week,' and 'still a lot you can do politically to ask for more,' this should be the 'opening of the door'.

Adam Huttler:  Such a 'wait and see mode,' not an 'advocacy strategy' on this.  Looking forward to everyone having one voice on this issue.

Alex Maiolo: Need a major simplification of complicated plans.  Deductibles, out-of-pocket maximum, drug costs... etc., 'we've got to stop that,' there's 'built-in obsfuscation,' and 'there's no reason this stuff should be complicated.'  If we've chosen to develop something that resembles the old system, 'let's stop confusing people,' meaning 'half a page' not a book.

Adam Huttler: That is part of the update - Bronze, Gold, etc., levels.  But, 'very vague requirement' in the law, lots of fine print to be sorted through.

 

How can states handle this?  What is the implementation going to look like?  States rights issues ahead?

Adam Huttler: Some states may accelerate the timetables, esp. those that are very pro-consumer.

Alex Maiolo: And the ones that don't implement in time?  May be laggards.

Kristin Thomson: How can you possibly figure out what is going to change, how can I possibly figure this out?  Are there other things musicians can be doing now? 

Marinaro: Trying to distribute as much information as possible.

Alex Maiolo: 'Reverse engineering' the way we've thought about plans.  Stuff like deductibles and out-of-pocket maximums will 'keep you out of the poor house,' and many of those things are not going to change.  Involves some dark, worst-case scenarios.  So, how much is the deductible covered, and what is the total maximum hit?  Pick a plan that would not bankrupt, and 'need to survive two, three years of chemotherapy' for example.  That 'basic philosophy is not going to change' moving forward.  So, don't bankrupt yourself and your band.

Kristin Thomson: Do HSAs change - Health Savings Accounts?

Marinaro: Will be more expensive to take money out for non-medical expenses. Over-the-counter may not be covered.

Adam Huttler: Big fan of HSAs (though they are high-deductible plans). Also, when you're buying coverage with more benefits, lower co-pays, etc., it helps the insurance companies - it is a business in the end.

Also, there are going to be some requirements for basic preventative stuff.  But, 'more concerned' about the stuff that is between preventative and catostrophic.

Kristin Thomson: Shout out to the Columbus Musicians' Co-op.

 

Question: Many plans required treatment in-state, doesn't really make sense for travelling musicians. In-state v. out-of-state plans.

Marinaro: Various plans allow out-of-state, emergency coverage almost always national.  But, not sure how health care reform will affect those tiers.  'Heads have to be falling off' typically for insurers to cover, extra days are problematic, etc.  And, in cases of non-threatening but painful illnesses, not sure - 'remains to be seen' under reform.

 

Question: Premiums going down?  But other reports say premiums are going up?

Marinaro: Kind of anyone's guess, though some streamlining could lower costs.

Adam Huttler:  A lot of that study - on higher premiums - may have been funded by insurance companies. 

Alex Maiolo: This reform plan can help private insurers, simply because it brings a lot of healthy people to the table. 

Adam Huttler: After all, it is saying, you have to buy their product.

 

Also:

Marinaro: New regs, cannot change rates based on your health status.

Public option, New York?

Marinaro: No, I don't see that happening.

 

 



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