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FOR SELF-EMPLOYED BUSINESS OWNERS, HEALTH COVERAGE IS AN ONGOING BATTLE BETWEEN FINDING AFFORDABLE MEDICAL INSURANCE AND BEING ABLE TO COVER ENOUGH OPERATING COSTS TO KEEP THEIR COMPANY VIABLE. By Michele Chiappetta
The No. 1 reason most people cite when they tell me why they’re not in business for themselves is health care. Navigating medical care without breaking the bank deters a lot of people from walking away from a full-time job. And it’s not hard to see why, especially if you have attempted to wade through these complicated waters without drowning. To me, health insurance and medical care have come to feel like the stock market, which is to say, it’s like taking a trip to Vegas to bet all my money, without the upside of cocktails and buffets to enjoy. It’s maddening to know I can make the smartest choice I can in health coverage that’s also affordable, and yet I can still get hit brutally in the wallet at the end of the year. I’m not alone. Other self-employed pals struggle with figuring out how to handle their health care too. And it’s not cheap. “My biggest bill, aside from rent and car, is health care,” says Gina Conroy, a single mom, teacher, and writer. She and I are in the same boat —
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trying to make ends meet without spending everything we have on health insurance. Interestingly, a lot of doctors don’t like the current minefield of health insurance either. “Physicians are getting frustrated with the current health care model,” says Scott Street, D.O., who provides direct primary care at Remedy Health in south Tulsa. “The model is what’s failing us; it’s not the providers. We want to provide good care for people and take care of them.” Owners of very small businesses — those with fewer than 50 employees — are not required by the Affordable Care Act to provide health coverage to their employees. But that doesn’t mean those employers don’t feel a sense of obligation to their employees or struggle with the decision to forgo a company plan. Especially since the ACA also mandates that each person have health insurance or face penalties. The individual mandate affects the business owners themselves, who
must purchase insurance plans for themselves and their families. In September 2016, the National Federation of Independent Business (NFIB) released a survey given to small-business owners, asking them to rank 75 issues according to how much it affected their business. The study showed 52 percent of small-business owners named the cost of health insurance to be a critical problem. The NFIB’s Small Business Problems & Priorities report also showed the cost of health insurance was the No. 1 issue facing small businesses, topping the list since 1986, and causing more concern than government regulations and federal taxes. If you’re in business for yourself, there are tons of numbers to add up and coverage options to evaluate. All of them take money out of your pocket. Picking a good option can feel like a crap shoot. But you have to start somewhere, and that’s what this particular article is all about. Here’s a quick overview of the options you
have in Green Country, their advantages and pitfalls.
SPOUSE’S INSURANCE If you’re married and your spouse’s company will cover you at a reasonable cost, consider yourself fortunate. Getting coverage through a spouse is an excellent option if the math is right. But do your homework first. Some companies only cover employees, not their families. Others (like my husband’s company) charge the full premium rather than a subsidized one to family members, which may make other coverage options cheaper (though not necessarily better). And many companies don’t offer coverage for partners who aren’t married.
HEALTH INSURANCE MARKETPLACE Whatever you think about the Affordable Care Act, you’re probably dealing with its repercussions. The marketplace subsidies are based on your estimated income for the upcoming year. The more money you make, the less assistance