Unfortunately, ASJA Can't Offer Health Insurance. Here’s Why.

Back in the 1990s, the Lambada and the Macarena were huge. Then one day my heart decided to beat to its own special rhythm. I’m still paying the price today, and it’s been anything but a dance party.

For reasons that are still unclear, my body decided to give me an irregular heartbeat when I was in my 20s. Nearly three decades later, it still beats funny. It’s not likely to kill me or require any treatment more than a cheap daily pill, but insurance companies still run screaming into the night when they see me coming.

I bounced through seven different health insurers for over 14 years. Each insured me for a while and then dumped my coverage, usually because it considered me too high of a risk to insure. You’ve heard of Dear John letters? I kept getting Dear Customer letters when Aetna or Cigna broke up with me.

For a while, my membership in ASJA gave me access to coverage, then it disappeared too. Hello, state high-risk plan with a waiting list and substandard coverage at high prices!

Once I went without coverage for 6 months in order to be eligible for a cheaper and better policy. Luckily, my crossed fingers didn’t give me a cramp requiring medical care. Then Obamacare came along and saved the day.

Plenty of other members used to get insurance via ASJA, and some hope we can restore the benefit now. We listened. A few months ago, ASJA President Milt Toby assigned me to explore health insurance options for our members. As ASJA’s representative, I joined a coalition of publishing industry organizations that investigated ways to offer coverage.

Unfortunately, I learned there’s no feasible way for ASJA to offer high-quality and reasonably priced health insurance coverage. We just can’t do it without putting our members at risk.

First, some background. For years, ASJA and other organizations of creators offered “association” health insurance through a firm that contracted with Cigna. The policies were available in certain states, including New York and California, and coverage was guaranteed. That means no one could be turned down because of their pre-existing medical conditions.

These policies were a godsend to people like me—self-employed, not old enough to get Medicare, without access to a spouse’s workplace health insurance, and with a pre-existing condition. Before Obamacare, it was extremely difficult for us to find coverage anywhere.

You can’t really blame insurance companies for not wanting to cover people who are sick or have certain health conditions. To stay afloat, they must ensure a blend of old and young, healthy and not-so-healthy. The premiums from healthier customers help subsidize the care of those who need a lot of medical services.

Everything changed when the Affordable Care Act (Obamacare) came along. Now, we can buy guaranteed insurance coverage through the federal and state “marketplaces.” The coverage is very good, but it tends to be expensive, especially for older people. I get my Anthem Blue Shield insurance through the California marketplace, and it costs more than $800 a month. (Yikes!)

The Trump Administration switched things up a few months ago by giving greater freedoms to “association” plans like the one that ASJA previously offered to members. ASJA could potentially join a plan and start offering coverage to our members.

But we aren’t going to do that. Here are a few reasons why:

Association plans aren’t well-regulated, and there’s tremendous potential for fraud. I know this first-hand, and so do thousands of other freelance writers. Back in the early 2000s, I got my guaranteed insurance coverage via the National Writers Union (NWU). The insurer turned out to be fraudulent—multiple defendants were convicted—and it failed to pay millions of dollars in claims.

Fortunately, I never needed medical care while I was insured. Other NWU members weren’t so lucky. They soon found themselves without insurance and with unpaid medical bills. Many had to fend off bill collectors and angry doctor’s offices, in some cases while they were quite ill and desperately searching for replacement coverage. I watched the devastation first-hand as a member of an NWU committee that tried to help members who’d lost their coverage.

Association plans don’t have to offer guaranteed coverage. They can turn down people who have health problems like me and, perhaps, you. It’s unlikely that any will offer guaranteed coverage.

Association plans don’t have to offer high-quality coverage. They may decide to not cover childbirth, hospitalization, prescriptions, psychiatrist visits or drug addiction services. In fact, they’re almost certain to offer substandard coverage because they need to compete on price with the Obamacare marketplace policies, which are mostly subsidized by taxpayer dollars.

Association plans aren’t likely to want to work with ASJA. Remember: Insurers can only survive if they ensure a mix of healthy and unhealthy, old and young. ASJA members tend to be in their 50s, 60s, and 70s. That means association plans aren’t going to want to take us on since we skew older (and sicker).

So, what are your options if you’re a self-employed writer who needs guaranteed-coverage health insurance due to your medical status?

You can get guaranteed coverage through the Obamacare marketplace that serves your state.  (Our president has been trying to strangle the Affordable Care Act, but it still—mostly—lives on.) It may be really expensive. But remember that it’s a business expense, and you’ll save on your taxes.

Medicaid and Medicare are options, of course, depending on your income and how old you are. And you may be able to join an organization and get health coverage through an association health plan. Keep in mind that it may be low-quality coverage, and it might be poorly regulated.

As for ASJA, we’ll keep looking for ways to serve you through helpful benefits. But for now, you’ll be on your own when it comes to health insurance.

Independent journalist Randy Dotinga is a board member and former president of ASJA.