It may seem hard to believe that the Affordable Care Act has been a thing for five years now, but it has. It’s managed to survive more political assassination attempts than Rasputin, and it’s become to healthcare insurance what Winston Churchill said democracy was to government: the worst of all possibilities, “except for all the others.” By that I mean that the ACA is the ultimate legislative platypus, a creature created by committee, one made up of people trying to scratch each other’s eyes out at the time. Had there been consensus, we could have wound up with something far less confusing and far more efficient. But we didn’t, so we have to make the best of what we have. And that’s important because most of those who man the touring consoles and rigs get 1099s around this time of year, not W-2s.
Pro audio professionals, touring-sound workers in particular, have evinced a love-hate relationship in recent years, not just with the ACA, but also with healthcare and insurance in general. Younger people have tended to avoid the topic based on a sense of invulnerability, while their elders opt out on either partisan principle or flawed economics, or both. The reality is, the ACA has helped millions of people get coverage that previously had been out of reach financially or inaccessible due to pre-existing conditions.
Goldman Sachs estimates that total coverage under the ACA increased the total number of Americans with health insurance by as much as 17 to 18 million. That’s despite the fact that, at the same time, the ACA has also made the health-insurance landscape far more complicated than ever. And there’s evidence that some younger people are coming into the market: a prescription management company review found that about 28 percent of people who enrolled in their plan in 2015 for the first time were 18 to 34 years old and skewing younger — their members in 2015 were 40.7 years old, on average, compared with 44.5 years old the year before. This is touring’s demographic wheelhouse.
Failure: An Option, but a Costly One
The ACA is confusing, and not knowing its ins and outs can be costly, not least of all because this year those who don’t get insurance will pay one way or another — the annual fee for not having insurance in 2015 is $325 per adult and $162.50 per child (up to $975 for a family), or two percent of your household AGI, whichever is greater (2.5 percent for the 2016 tax year). There’s help out there now, though, and it’s aimed directly at touring-sound workers as well as the musicians they’re mixing on stage. Two entities — one for-profit, one non-profit, and both based, not surprisingly, in Nashville — offer healthcare-insurance navigation services tailored to those in The Biz.
Sound Healthcare
Sound Healthcare & Financial (soundhealthcare.org) has been around since 2006. Founder and CEO RJ Stillwell, who dabbled on the creative side before going into insurance, recognized that entertainment professionals often had extreme difficulty when navigating the process of obtaining affordable coverage that addressed the needs of their lifestyles. “Frequent travel, non-status quo working arrangements and other characteristics of the creative life just didn’t figure into the cookie-cutter approach offered by traditional insurance brokerages,” he states. Since the ACA came into being, Stillwell’s company has focused on that, trying to match needs and budgets with various plans and insurance companies. That’s not easy, considering that some markets have as many as five or six providers and hundreds of plans between them. The alternative, in states that decided not to create and operate their own insurance marketplaces and left it to the Federal government to manage, is no better, with far fewer choices that lead inevitably to higher premium costs.
What Stillwell has done is create alliances with a range of interested organizations, including the AES, the Recording Academy, the American Federation of Musicians and others, and is using focused conferences and events, such as the TourLink Conference and the Touring Career Workshop, to funnel information to a very specific audience. In the process, Stillwell has found that attitudes towards health insurance are changing.
“The touring sound person has become much more inclined to get insurance coverage in recent years,” he told me. There’s been a fundamental change in attitude and a realization, mainly among younger professionals, about the stress and other dangers that come with working on the road. “I’m seeing much greater attention to what they need to do to protect themselves,” he says. “We’re getting an overwhelming response from them at these events.”
Music Health Alliance
Another entity, the Music Health Alliance (musichealthalliance.com), is a non-profit that asserts to have helped 3,700 music industry professionals get medical coverage in its three years of existence. Tatum Allsep, the organization’s founder and executive director, says they go well beyond simply navigating clients through the twists and turns of Obamacare; they also help to negotiate medical costs for indigent clients. As she puts it, “We protect, direct and connect,” providing accurate information, identifying resources and linking clients with an assortment of resources, such as MusiCares, or identifying appropriate individual grants.
Both Sound Healthcare & Financial and the Music Health Alliance make small commissions from each new policy taken out by those who rely on their guidance. Sound Healthcare is for-profit, but Stillwell says the ACA’s provision that insurance companies must spend a minimum of 80 percent of their revenues on actual insurance services (as opposed to salaries and bonuses) has caused commissions to be slashed in half, in the process driving nearly half the medical insurance brokers out of the business since 2012 by squeezing brokerage profits.
Both entities are based in Nashville, but both can extend their reach considerably. Sound Healthcare & Financial is licensed to work in a dozen states, mainly in the South, but also in the entertainment-technology centers of New York, Los Angeles and Austin; the Music Health Alliance is available in those cities and Atlanta and Miami as well.
Now that the Affordable Care Act has lasted longer than most bands, and now that it’s baring its teeth with penalties for not signing on for insurance, it makes no sense to be without medical insurance. Until they come up with a plug-in for a new liver, this is the best deal since sliced bread.
