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Can Freelance Professionals Benefit From The Affordable Care Act?

In light of the major healthcare reforms that have been under way since 2010, many Americans are wondering how their occupation will affect their future access to healthcare.

Freelance professionals are among the most unique of these groups, since freelancing and consulting work spans nearly all disciplines and income levels. In this regard, a freelance designer who makes next to nothing is in the same boat as a well-paid, freelance architect.

And it’s not just because neither of these individuals has a salaried job.

The struggling and successful freelance professionals, and all others in between, share a similar relationship to healthcare: they do not have access to employer-provided group-rate care, which means, that the majority of these individuals pay way too much for private insurance. It also means that individuals on the low-income end of the spectrum may not be able to afford health insurance at all.

Until recent years, there was no talk of anything changing, and it was pretty much understood that going into the freelance sector meant limiting your access to good, affordable healthcare.

Upcoming changes to the American health care system will mean more choice and access for all, but that promise offers little comfort to the millions of hardworking Americans who do not have adequate health insurance, if any at all.

An informed introduction into what the plan will actually do may provide some help to this end.


The Affordable Care Act is an alternative to the current system, which many Americans view as broken. Healthcare companies have held court for a long time over things like eligibility requirements, coverage specifics, and pricing, at the expense of the consumer.

The ACA enacts, among other things, a system of online marketplaces for purchasing health insurance, where companies pay to be included, and individual consumers are able to choose which plan and provider works best for them.

Individuals, in this case, are sole proprietors, individual consumers, freelancers, and anyone else who isn’t already insured by an employer, a parent, or a government sponsored program such as Medicare. All Americans are mandated to have insurance by January 2014. If they choose to go without insurance, they will be fined a rapidly increasing fee of $95, which will be raised yearly until 2016, when it will be tied to the rate of inflation.

States are required to set up these online marketplaces, in which plans will be offered at four levels, from bronze to platinum, accordingly. The pricing of plans and providers will be adjusted to meet the income of the consumer, as opposed to deepening the pockets of healthcare executives.

How it will work is as follows: plan costs will be capped at a certain percentage of annual income, when viewed in relation to the federal poverty line. Individuals who make less money will pay less for insurance, and individuals who make more money will pay an equally fair percentage of their income toward insurance.

The annual income scale for consumers is 138 to 400% above the Federal Poverty Line. Those who fall below 138% of FPL may be eligible for Medicare.

Employers with more than 50 employees are mandated to offer health insurance under the ACA, and the states are required to have separate marketplaces in place for employers, in which they can purchase insurance.

Other unique aspects of the Act include guaranteed issue and renewal policies that must be met by all health plans, and a long list of required health services, which includes emergency and inpatient care, among other services. Notably, providers will be unable to deny coverage to individuals based on pre-existing conditions, which is a big step for Americans everywhere.

This is all good news for Freelance professionals, who have too often been wronged by unaccountable insurance companies and inane practices. The ACA aims to obliterate this possibility, and make the healthcare companies accountable to the needs of the people.

The online marketplaces open on October 1, 2013, with full implementation of plans set to go into effect on January 1, 2014.

Essential Benefits: What Matters Most

The core benefits of the ACA provide individuals with the security they have been looking for, and a well-needed sense of protection from insurance companies.

Guaranteed issue, renewal, and non-discrimination based on pre-existing conditions, means consistent care for Americans who suffer from chronic illnesses, and Americans whose healthcare is dependent upon their income.

The list of required services is a fine expansion of this ideal, in that it provides access to necessary services without the fear and anxiety associated with denied coverage. The list includes the following services, to name a few: Rehabilitation Services, Newborn and Maternity Care, Mental Health Services, Inpatient Treatment Services, Lab Services, Testing,
Child Care, Emergency and Ambulatory Services, Oral and Vision Care, Substance Abuse Services, and Wellness.

The most important thing to remember about all this is that these requirements apply to ALL plans, regardless of provider or plan level. So you’ll be protected, no matter what.

Medicare: For Those Who Cannot Afford Insurance

Generally speaking, states offer Medicaid to individual families, or elderly individuals, with an annual income range that is below 100% of the Federal Poverty Line.

A Medicaid expansion is included in the ACA, and although states are not required to adhere to it, this expansion is already being implemented in a number of regions, including New York and New Jersey.

The expansion raises the income level to 138% above the FPL, which increases eligibility. It also makes single childless adults eligible for Medicaid for the first time.

Subsidies That Can Help You Afford Insurance

When push comes to shove many of us with good jobs and inadequate insurance are concerned about cost.

The ACA aims to lessen this worry by offering tax credit subsidies to individuals under the age of 65, with an income level between 138 and 400% of the FPL. These breaks can be considerable, and provide you with the plan you need, at a price that won’t make you nervous.

The number of tax credits you can receive is determined by the usual factors: income, dependents, and marital status. If you fall within this income range and money is a concern, this possibility is worth looking into.

A Better Life For Freelance Professionals

All in all, it seems as though Freelance Professionals, and millions of other Americans, will benefit greatly from the new healthcare legislation.

Although many journalists and everyday people discuss the logistical issues of the Act, and engage in collective skepticism regarding its implementation, the goal of providing a better life for people and their families seems likely win out over any other preoccupation, no matter how important it may seem.

Health and people come first for most of us, and with any luck, these values will be reflected in our policies come January, and for the long term, so that Americans can count on their system of government to provide them with the services they need to keep on living.

Michael Cahill is the Editor of the Vista Health Solutions Blog. He writes about the health care system, health insurance industry and the Affordable Care Act. For more information about the ACA may affect freelancers and other options for health insurance, visit the Vista Health Solutions self employed health insurance guide. Follow him on Twitter at @VistaHealth

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