Americans have started to think a little differently about work during the pandemic. Priorities have changed; many withdrew on their own.
Titus Prather of Nashville, 24, is ready to join the growing ranks of the self-employed.
“I’ve been in construction for four years now,” he says. “But I’m actually preparing to make the transition to self-employment, so I can start building my own construction business.”
Prather hopes to build custom homes here in Nashville, where the housing market has been still buoyant in recent years. But to cash in on the local housing boom, he needs to make sure medical bills don’t eat up all of his profits.
About a decade after the Affordable Care Act market debuted, the exchange of individual health plans finally seems to be hitting its stride. A record number of Americans, 14.5 million, purchased plans for this year. And with open listing underway – ending Jan. 15 for the federal market – the upward trend is expected to continue, linked to several lingering effects of the pandemic.
The day the open enrollment period began, Nov. 1, Prather met with a health plan navigator to lock in a policy for her growing family.
“And I’m having a baby soon, so make sure everything is in order for my family,” Prather said.
Deadlines vary from state to state, but Prather has until Jan. 15 to get all of her paperwork in order to lock in a subsidized plan. Nearly three-quarters of people who sign up qualify for discounted monthly premiums, which fell last year to an average of $133 per month.
But it’s not just the self-employment boom that’s pushing people into these plans. It is also a fear created by COVID.
“The pandemic hasn’t discriminate,” said Aida Whitfield, who oversees Obamacare navigators in Tennessee.
When the Affordable Care Act plans first became available, many young, healthy people didn’t think it was worth signing up for. This hard-headed band has even earned the nickname “Invincible Youth.” But many feel a little less invincible these days.
“For a lot of young people, also seeing other young people going through the pandemic and having COVID and going through the worst part of it, I think they realize, ‘OK, that could be me tomorrow,’” said said Whitfield.
More generous subsidies also make Obamacare plans more attractive, and they have been extended until at least 2025.
Another factor at play this year that has analysts believing ACA exchange numbers will continue to rise is a regulatory tweak for what was called the “family issue.”
“Basically, there had been people — mostly spouses and children of people covered by the employer — who had been blocked from getting subsidies,” said Cynthia Cox, ACA program director at Kaiser. Family Foundation.
If your spouse had a job that offered insurance for the whole family, even if it was expensive, you couldn’t get the big discounts. Now that has changed. Another million people could enter the market for this reason, Cox said.
The more entrepreneurs, healthy young people or families in the market, the more stable it will become in the long term, she said. The individual Obamacare market got off to a rocky start. Cox has been following from the start.
“Certainly in the first two years that these markets were open, there was a lot of volatility,” she said. “The premiums have gone up a lot. Insurers were leaving the market. There were counties in the United States where it was not even clear if there would be a single insurer offering this coverage. But all that has passed.
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