Self-employed people weigh returning to corporate jobs if Senate passes ACA repeal bill
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • CMS finalizes drug transparency, pharmacy quality rules
      More than 4M patients had data exposed in December-reported breaches
      MD Anderson wins appeal over $4.3M HIPAA penalty
      CMS approves rule forcing insurers to ease prior authorization
    • Biden unveils $1.9T plan to stem virus and steady economy
      Nursing home staff COVID-19 vaccination: A work in progress
      California hospitals prepare ethical protocol to prioritize lifesaving care
      Expanded vaccine rollout in U.S. spawns a new set of problems
    • Trenda Ray
      Q&A: Arkansas nursing leader looking for creative staffing solutions as COVID cases surge
      The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      Cook Lydia 4x6_i.jpg
      Northeast Ohio health systems increase community benefit values in 2019
      Vaccine rollout hits snag as health workers balk at shots
    • CMS approves rule forcing insurers to ease prior authorization
      COVID-19 still a big uncertainty for insurers in 2021
      Health insurers' outlook boosted after Dems' Georgia win
      humana_i.jpg
      Humana supports Ohio not-for-profits with $500,000
    • CMS approves rule forcing insurers to ease prior authorization
      Verma: CMS tried to ‘infuse' free-market competition across healthcare during Trump era
      CMS axes MFAR rule for good
    • Operation Warp Speed to bump up McKesson's stock price
      Reporter's notebook: J.P. Morgan's 2021 health conference
      Hospitals, nursing homes get more time to file cost reports
      Hospitals' 2020 fundraising on pace to top 2019
    • 5 things to know about Google's $2.1B Fitbit acquisition
      Providence bets on machine-learning, consolidating data centers
      Mental health treatment was most common telehealth service during COVID
      Broad, Verily take Terra bioinformatics platform to Microsoft Azure cloud
    • Chance of COVID-19 triage care looms over Arizona hospitals
      U.S. ramps up vaccinations to get doses to more Americans
      367146427.jpg
      Should businesses mandate that staff get the COVID vaccine?
      Smartphone
      'No mobile phone' phobia on the rise
    • Tower Health's finance chief resigning after years of steep losses
      AHRQ director Gopal Khanna resigns in response to Capitol riot
      Brigham president stepping down after Moderna controversy
      Dr. Kenneth Davis
      Mount Sinai CEO offers lessons from one of the nation's first COVID recovery clinics
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • New care model helps primary-care practices treat obesity
      doctor with patient
      COVID-19 treatment protocol developed in the field helps patients recover
      Rachel Wyatt
      Project to curb pressure injuries in hospitals shows promise
      Yale New Haven's COVID-19 nurse-staffing model has long-term benefits
    • Modern Healthcare InDepth: Breaking the bias that impedes better healthcare
      Videos: Healthcare industry executives describe their encounters with racism
      Michellene Davis
      Healthcare leadership lacks the racial diversity needed to reduce health disparities
      Dr. James Hildreth
      How medical education can help fight racism
      Quotes from rebadged employees
      Outsourcing IT, revenue cycle takes toll on internal culture
    • A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      self service station
      COVID-19 pushes patient expectations toward self-service
      Targeting high-risk cancer patients with genetics
      A nurse holds up a phone with a message to a family member saying surgery has started.
      Texting, tablets help hospitals keep family updated on patient care
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Highmark Health inks six-year cloud, tech deal with Google
      Study: 1 in 5 patients report discrimination when getting healthcare
      HHS proposes changing HIPAA privacy rules
      Android health records app launches at 230 health systems
    • California hospitals prepare ethical protocol to prioritize lifesaving care
      Amazon, JPMorgan Chase, Berkshire Hathaway disband Haven
      Digital pathways poised to reshape healthcare continuum in 2021
      Healthcare was the hardest hit by supply shortages across all U.S. industries
    • A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      New care model helps primary-care practices treat obesity
      How hospitals are building on COVID-19 telehealth momentum
      Researchers: Hospital price variation exacerbates health inequities
    • MedPAC votes to boost hospital payments, freeze or cut other providers
      Most Next Gen ACOs achieved bonuses in 2019
      Congress recalibrates Medicare Physician Fee Schedule after lobbying
      CMS approves rule to encourage value-based drug pricing
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
      Dr. Bruce Siegel
      Why taking a hospital not-for-profit was Dr. Bruce Siegel’s boldest move
    • Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
      John Daniels Jr.
      Health equity: Making the journey from buzzword to reality
      Mark C. Clement and David Cook
      We all need to 'do something' to fight inequities and get healthcare right, for every patient, every time
    • Healing healthcare: some ideas for triage by the new Congress, administration
      Dr. Sachin H. Jain
      Medicare for All? The better route to universal coverage would be Medicare Advantage for All
      Connectivity: a social determinant of health that can exacerbate all the others
      Taking my shot at building trust
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Best Places to Work in Healthcare Logo for Navigation
      Nominations Open - Best Places to Work in Healthcare
      Nominations Open - Health Care Hall of Fame
      Nominations Open - 50 Most Influential Clinical Executives
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Social Determinants of Health Symposium
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala (2022)
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Carter Dredge
      Next Up Podcast: Ready, set, innovate! Innovation and disruption in healthcare
      Next Up Podcast: COVID-19, social determinants highlight health inequities — what next?
      Ceci Connolly
      Next Up Podcast: How to navigate the murky post-election waters
      Next Up Podcast: Saving Rural Health
    • An older man wearing a mask receiving a vaccine.
      Beyond the Byline: Verifying information on the chaotic COVID-19 vaccine rollout
      doctor burnout
      Beyond the Byline: How healthcare supply chain struggles contribute to employee burnout
      Beyond the Byline: Covering race and diversity in the healthcare industry
      Beyond the Byline: How telehealth utilization has impacted investor-owned company earnings
    • Leading intention promote diversity and inclusion
      Introducing Healthcare Insider Podcast
    • The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      The Check Up: Dr. Kenneth Davis
      The Check Up: Dr. Kenneth Davis of Mount Sinai Health System
      The Check Up: Dr. Thomas McGinn
      The Check Up: Dr. Thomas McGinn of CommonSpirit Health
      The Check Up: Mark Ganz
      The Check Up: Mark Ganz of Cambia Health Solutions
    • Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
July 24, 2017 01:00 AM

Self-employed people weigh returning to corporate jobs if Senate passes ACA repeal bill

Harris Meyer
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print

    Steven DeMaio of New York City has been happily self-employed as a writer and editor since 2008. At that time, he felt comfortable leaving a corporate job with health benefits and going out on his own because the state where he then lived, Massachusetts, had established a system guaranteeing affordable individual-market coverage without regard to health status.

    But DeMaio, 46, recently decided to look for a corporate job with health benefits because of uncertainty over the future of his health insurance posed by Republican efforts to repeal and replace the Affordable Care Act. As of Aug. 1, he will begin working for a company that offers a group health plan.

    "My first preference would have been to remain self-employed," he said. "I do want to work for this firm, but I wouldn't have started looking in the first place if not for all the political chaos and rhetoric threatening the ACA. There's a huge question mark about what the insurance markets will look like in 2018."

    DeMaio is one of many self-employed Americans who are watching with high anxiety as Senate Republicans debate this week whether to replace the ACA or simply repeal most of the law.

    Being able to buy affordable insurance regardless of pre-existing medical conditions under the ACA has freed many people like DeMaio to leave jobs with health benefits to launch their own businesses. It has loosened what both Republicans and Democrats long have criticized as job lock associated with this country's job-based health insurance system.

    There are an estimated 23 million self-employed entrepreneurs in the U.S., according to the federal Small Business Administration. A 2008 Harvard Business School study estimated that 11 million people were caught in so-called job lock tied to health coverage. Economists say job lock crimps the dynamism of the U.S. economy, discouraging entrepreneurs from developing potentially successful new products and services and reducing the number of startup firms that may go on to hire workers and boost the economy.

    I wrote about this issue in December and interviewed a number of young entrepreneurs who said they were emboldened to go off on their own because of the ACA's guarantee that they'd be able to buy a health plan without being discriminated against based on their pre-existing conditions. I checked back with them this month and talked to several other self-employed people to see if the thinking of this group had changed as GOP repeal efforts advanced.

    What they said is they're following the Republican healthcare legislation obsessively and are thinking hard about whether they will be able to continue their businesses or will have to pursue alternatives, including seeking jobs with health benefits.

    They're talking with their significant others, business partners and colleagues and deciding whether to try to tough it out no matter what the new GOP model looks like, sell their business, get on their significant other's employer plan, or move to another state or even another country with a universal healthcare system.

    But mostly they're hoping the GOP repeal effort fails—or at least that Republicans preserve the ACA's protections for people with pre-existing conditions.

    GOP leaders say they intend to maintain those protections and that their legislation would make premiums more affordable. But this week Senate Republicans are considering waivers for states and insurers allowing them to offer health plans that experts say would not provide the same safeguards in terms of essential benefits, guaranteed issue regardless of health status, community-rated premiums, and caps on out-of-pocket costs. The Congressional Budget Office has said the Senate bill would substantially increase costs for some people with medical needs.

    "Maybe I'm wrong, but I'm increasingly confident that the Cruz amendment (allowing insurers to sell plans that lack ACA protections) doesn't go forward," said Namir Yedid of San Diego, a self-employed technology developer and cancer survivor who's in his 30s. "If it does, it's a different ballgame."

    "I'm terrified of losing my insurance and I'm also worried about my entire community," said Lucia Gerdes, 38, a breast cancer survivor who opened the successful Cedar Mountain Café in rural western North Carolina with her husband three years ago. The café is one of the biggest employers in that area, with 10 to 15 employees during tourist season.

    She said if the ACA is repealed or replaced with a system that doesn't offer affordable coverage for someone with a pre-existing condition such as hers, "We've talked about selling the business and perhaps moving to a more Democratic state that sets up a single-payer system. We're planning for a crisis. Everything is on the table."

    Joshua Lapp, who launched a successful Columbus, Ohio-based urban planning firm in 2014, is also weighing his alternatives. "We have begun to explore what our options would be as a firm should something pass," said Lapp, who's in his late 20s and has congenital heart disease.

    Lapp hopes he's able to keep the ACA protections and continue his business. "There are so many unknowns and there seems to be an inability (good for me!) of being able to pass an actual bill," he said in an email. "So for now I'm just going on as I was before, paying my monthly premium and hoping for the best."

    DeMaio believes the threat of ACA repeal is having a chilling effect on entrepreneurs and people considering launching their own businesses, forcing people to hang on to jobs they know they should leave or apply for positions they don't want. "I don't think any small business or self-employed person wants that kind of volatility," he said.

    Gerdes is angry about the current political situation. "I shouldn't have to leave my business that I've shed blood, sweat, and tears over, working 80 hours a week," she said. "It's so sad to think we'll have to sell everything we built because we may not have healthcare."

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Verma: CMS tried to ‘infuse' free-market competition across healthcare during Trump era
    Verma: CMS tried to ‘infuse' free-market competition across healthcare during Trump era
    HHS to distribute $22 billion to aid COVID-19 testing, vaccination
    HHS to distribute $22 billion to aid COVID-19 testing, vaccination
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
        • Social Determinants of Health Symposium
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala (2022)
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing