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The nation's looming health care crisis -- 40 million without health insurance, insurance premiums rising, and benefits being reduced -- has made headlines of late. The most startling news is that, in the midst of a recession, health care costs are expected to rise between 13 and 16 percent in the next year. Like many New Yorkers, artists are already beginning to experience changes in their access to health insurance and care.
By some estimates, four of every 10 artists lack health insurance, compared with 14 percent of the total population. This is not because artists are unemployed, however. Like the vast majority of the uninsured, artists tend to lack insurance because they work for employers who do not offer health care; the sporadic, project-based nature of the working artist's career is a major hurdle to health insurance. This is not news to the many actors, musicians, painters, and dancers who keep the day job as much for the benefits as for the steady check.
Complicating this factor, according to a new report from the Future of Music Coalition, is the fact that artists are often considered by insurance companies to be a "risky" population. Whether because of their long hours, frequent travel, repetitive stress disorders, and such job hazards, or because, as the coalition's report suggests, because of an anti-arts bias based on the "hypothesized decadence of art culture," the reality is that it is hard for artists to get access to coverage on their own, even if they could afford the high premiums charged for individuals. In 2002, premiums for the major individual health plans serving New York ranged from $400 to $500 per month for individuals and well over $1000 per month for families.
Major arts unions like the Writer's Guild of America, American Federation of Television and Radio Artists, the American Federation of Musicians, and the American Society of Composers, Authors, and Publishers form a safety net for many artists by offering subsidized group health coverage. However, unions are now feeling the same pressures that are causing employers to pass on more of the costs of health insurance to their employees. (In a Commonwealth Fund/Health Research and Educational Trust survey published last month, the majority of New York State employers said that they plan to pass on more of the costs of health insurance to their employees next year.)
The Screen Actor's Guild has already announced that, starting in January, they will begin to charge enrollees a monthly premium for the first time, either $50 or $65. The benefit plan will also become less generous, charging higher deductibles and copayments and covering fewer services. The change that will affect the most members is that eligibility requirements will be substantially tightened. In 2003, actors will have to earn $20,000 to qualify for one plan or earn $9000 or work 61 days to qualify for another. These changes, the union trustees say, are absolutely necessary to prevent health costs from eating through its assets within the next two years. In May of this year, the guild extended Rule One, which requires that producers dedicate 13.8 percent of actors' salaries for health and pension plans, to all productions worldwide in another effort to shore up the health plan's funding.
Health care is a more pressing issue now because of rising costs, but the arts community has long been advocating for improvements to access to health care for artists. The explosion of HIV/AIDS in the arts community in the 1980s galvanized many to fight for better health care for the dying; now Broadway Cares/Equity Fights AIDS helps those living with the virus. In the mid-1990s, New York-based Actors' Fund won a grant from the National Endowment for the Arts to mount the Artists' Health Insurance Resource Center, a central clearinghouse that educates artists about health insurance options. The online database provides information about group health plans, federal and state public programs, options for the self-employed, and advice on how to get and keep insurance. According to James Brown of the Actors' Fund, the recently redesigned website gets about 650 individual users a day, half of which live in New York City.
Since 2000, the Actors' Fund has also been running the Physician Volunteers for the Arts, which serves the uninsured and underinsured members of the performing arts community. Free clinics staffed by volunteer physicians provide basic health services and referrals for specialized treatment.
Assemblyman Richard Brodsky is sponsoring a bill in the state legislature that would pay for 50 percent of the COBRA premium for up to six months for eligible members of the entertainment industry. COBRA, or the Consolidated Omnibus Budget Reconciliation Act, guarantees employees leaving employer-sponsored coverage the right to buy into that coverage for up to 18 months. While the law provides continuity of care, its premiums -- around $350 for individuals and more than $1000 for families in New York in 2002 -- prove out of reach for many, particularly for those who have recently lost their jobs. Brodsky's bill would subsidize 50 percent of COBRA coverage to qualifying members of the entertainment industry (e.g., screenwriters, actors, musicians, dancers) for up to six months.
Such measures, while crucial, may only be damage control. Increasing problems with access to and continuity of care in the arts community are one more sign that major legislative reform to the health care system is needed.
Martha Hostetter writes for American Theatre magazine.
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