Health insurance: a challenge for freelancers

I have to admit that I haven’t been following the evolution of the health insurance reform legislation in Congress. That’s because it was making me sick. When I saw old people whipped into a frenzy by Republican extremists circulating misleading information about government death panels, I simply tuned out. It’s just not worth raising my blood pressure over. Literally. If I get sick, or even if I go to the doctor for my annual checkup, I pay out of my own pocket. At least, the first $2,600 of it every year.

That’s the deductible on the health insurance plan that I buy through the State of Maryland. You see, I have personal experience with a “public option,” and not by choice. When I went out on my own as a freelance writer, I could not buy private health insurance. It’s not that I could not afford it. It’s that no private insurer would sell me a policy. At any price.

No, I don’t have a terminal disease. I’ve never had cancer. Don’t have HIV. Or a heart condition. Or even high blood pressure. (For some reason, it’s incredibly low. A nurse once asked me if I was dead.) However, like anyone who’s been on the planet awhile, I do have a few conditions, none of which I consider particularly serious. But apparently the arthritis that I was diagnosed with in my mid 40s – just a few months before I left my job to freelance full time – is enough to make me a leper in the world of private health insurance. No one would touch me.

Maryland is one of 35 states that maintain “high-risk pools” for people who are denied private coverage. The premiums are typically higher than private insurance, unless you fall below a certain income, at which point the rates are partially subsidized. The system has worked well for me so far. I pay my premiums and also contribute regularly to a health savings account, which I can tap into to pay for my own healthcare costs up to the amount of the deductible. Because I pay out of my own pocket, I make more careful choices about what healthcare services to use. I’ve found some helpful sites on the Web (like that tell me what the going rate is for certain services, like x-rays.

I’m grateful, and lucky, that Maryland has such a plan. Freelancers in states without high-risk pools have tough choices. They could become a part-time barista at Starbucks, a company that provides insurance even to part-time employees. They could change their marital or dependency status. (Recently, a friend’s 23-year-old daughter left a job and thought she would buy private insurance, only to find that – because of a melanoma removed from her leg 10 years ago – she was denied. She and her boyfriend moved up the wedding by a year so she could get onto his policy.) They could return to the full-time, traditional workforce.  Or, if they are healthy and feel lucky, they could risk going without insurance.

Whether through a state-run program or by manipulating the private system, people like us are getting by, at least some of us are. Anti-reform zealots complain about the government rationing healthcare. The fact is, healthcare is already rationed – by big companies whose obligation is to make profits, not protect the health of citizens. If we don’t get meaningful reform now, we will in a few years, as a larger percent of the population experiences the arbitrariness and unfairness of the current system in America.

2016-12-17T02:03:33+00:00 Business, Healthcare, Writing|


  1. Susan Troll RN February 17, 2010 at 1:12 pm - Reply

    I like your comments and personal viewpoint. As a hospital nurse, I see first hand some of the abuses of the health care system.

    The idea of rationing has been so overdramatized. I see pointless and futile “services” being provided daily…if people had to pay up front for some of their treatments, they might take more personal responsibility for their health!

  2. […] Quality, affordable healthcare. I’ve posted about this before, both here and here. The single most difficult part of being a freelancer is obtaining and paying for health insurance. […]

  3. […] when I went full-time freelance in my mid-40s eight years ago. (You can read about my adventure here.) If it hadn’t been for the State of Maryland’s high-risk pool, which forces a private insurer […]

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