By Daniel Chang
The Miami Herald
WWR Article Summary (tl;dr) Obamacare has been a real boon for entrepreneurs and other independent workers, who are almost three times as likely to buy an ACA plan than other workers. This article takes a look at one entrepreneur in particular who is very concerned about any sort of repeal.
The Miami Herald
With two daughters heading to college, Suzanne Boyd was ready to take her fledgling business to the next level and make it her full-time career.
Boyd had run a special-events business for years on a part-time schedule that fit around her other responsibilities — driving the kids to and from school, helping them with homework, preparing meals and keeping up the family home in Cooper City.
But five years ago, when the empty nester finally got the chance to spread her entrepreneurial wings, Boyd said, it wasn’t the business plan or the financial risks that kept her up at night. It was her diagnosis of lymphatic cancer and the uncertainty of how she would pursue her dream career without the safety net of health insurance.
She eventually found insurance through the Affordable Care Act. The coverage she got through the program also known as Obamacare saved both her health and her career, she said. But as politicians in Washington consider whether to repeal and replace the program, she’s terrified that she might have to go without insurance at age 56.
“I don’t have a choice,” Boyd said of her need for health insurance. “I can’t afford to be without it.”
Like some 150 million Americans, Boyd had been covered for years by an employer-sponsored health plan at the entertainment company where her husband, Mark, worked. When her eldest daughter was ready to leave home for college, Boyd figured she would finally have the time to devote to her business.
Then, in April 2012, Mark Boyd died of lung cancer.
“That’s when everything started spiraling, from there, because he was truly the bread winner,” Suzanne Boyd said.
Two weeks later, the family lost their employer-sponsored health insurance. And Suzanne Boyd — widowed and uninsured — was diagnosed with Hodgkin lymphoma five months after that.
“A lot of people get sick. But when it comes to what happened, we had a double, triple whammy,” she said.
Before the ACA, Boyd says she wouldn’t have even considered starting her business, The Party Company. She probably would have looked for another corporate job with health benefits.
But in July 2013, she launched the company, knowing that the ACA would be offering insurance coverage to individuals five months later and that her pre-existing condition — Hodgkin — couldn’t be held against her when she applied. She eventually qualified for a plan that cost her $192, with substantial government subsidies.
“It works, and it’s amazing,” Boyd said of her coverage.
Obamacare has been a real boon for entrepreneurs and other independent workers, who are almost three times as likely to buy an ACA plan than other workers, according to new data from the Treasury Department.
More than one in five customers of the ACA’s exchanges in 2014 was a small business owner or entrepreneur — about 1.4 million people, the report said. As enrollment in the ACA exchanges has risen, the Treasury Department report noted, “coverage among independent workers has almost certainly risen as well.”
In Florida, about 178,000 people with their own businesses had coverage through the ACA exchanges in 2014. That’s about 15 percent of all self-employed individuals in the state, according to IRS tax filings for that year.
And it’s truly small business owners who are using Obamacare. Those who earned less than $65,000 a year were the most likely to rely on the ACA exchanges for coverage.
Health insurance coverage, once a potential barrier for people who wanted to start a business, has become easier to obtain since the ACA, said Katie Vlietstra, vice president of the National Association for the Self-Employed, a nonprofit membership group for entrepreneurs.
“The insurance component has always been an issue and a strain,” said Vlietstra, whose group represents 27 million members.
“It’s kind of the dark cloud of entrepreneurship.”
The ACA even transformed the NASE, Vlietstra said. The group was created in 1981 to provide its self-employed members access to group health insurance. That’s no longer very important since the ACA came into being, she said.
“Our members have benefited from the Affordable Care Act,” she said, “and I think that there are many of them who are very concerned about what’s going to happen and how these reforms — or if you want to call them repeal efforts — are going to impact them and their families.”
On average, employers contribute close to 80 percent of the cost of a single worker’s health insurance premium, according to the Robert Wood Johnson Foundation.
As GOP leaders work to repeal the health law, it remains unclear whether those with pre-existing conditions — like Boyd’s cancer — will remain protected.
“The pre-existing condition was the big issue” for entrepreneurs, Vlietstra said. “It’s insane it was a disqualifier. It’s insane we’re even talking about it going away.”
For Boyd, the issue came into focus when she was diagnosed with cancer. (Her diagnosis of Hodgkin’s was later reclassified as non-Hodgkin lymphoma.) Her finances were already depleted from costs related to her husband’s illness and death. And she still had to pay tuition for her daughters’ school.
So buying coverage on the individual insurance market was costly but critical. Then the insurer, Humana, dropped her in the middle of chemotherapy, citing her illness as a pre-existing condition.
She pauses and gets choked up as she recalls being denied care: “One day I was there for my chemo, and they wouldn’t give it to me. I had to leave. I left the hospital.”
By the time she was able to get insurance under Obamacare in January 2012, Boyd estimates she had racked up more than $100,000 in unpaid hospital bills and other medical debt during the period when she was uninsured. She said doctors and nurses at the University of Miami Health System’s Sylvester Comprehensive Cancer Center helped her apply for emergency Medicaid and other forms of coverage, including the hospital’s charity care program.
When she finally had insurance — she bought a plan offered by Coventry — it covered the cost of radiation therapy and a stem cell transplant, treatment that helped send her cancer into remission in May 2015.
Knowing what life was like before the ACA, Boyd said she’s worried that she may not be able to keep The Party Company going full-time if the law is repealed or replaced with something that doesn’t work as well. She’s also angry that 20 million Americans could lose the coverage they gained under the law.
It works, and it’s amazing.
“It was very difficult to get any type of coverage before this happened,” Boyd said of the ACA. “When you look at how many people are covered, I just cannot believe that America is going to let this happen, to just take it from under us.”
Setting up a picnic for 80 people under a white tent at Virginia Key Beach Park on a breezy weekend in February, Boyd reveled in the details of her work — making sure the shaved-ice machine worked properly, cutting sunflowers to adorn the tables, checking on the buffet-style lunch set up at the concession stand.
Though she loves her job, Boyd said, life’s not perfect. She worries that her cancer could return, a constant concern that can transform even a mild cough into a paranoid rush to the hospital for a chest X-ray — something Boyd did recently during a bout with the flu.
The cough, it turned out, was caused by a bacterial infection. And her health insurance would have covered her had it been something worse.
“I was like, ‘OK, I’m normal, like the rest of the people,'” she said. “I can’t even tell you how reassuring it is.”