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Health Care Reform

Health Care Reform and the Music Industry

How is Health Care Reform going to impact the Music Business? Well, I am not going to lie, it is going to be a chaotic mess for a little while. There are currently more unknowns than knowns about the implementation of this new law and with an industry that is under insured, the sales predators are going to be on the prowl using every devious scare tactic in the book to get our attention. However, there are more resources available to the music industry than most, so please find comfort in knowing that Music Health Alliance will be here to navigate with you along the way. We are partnering with MusiCares in the coming months to make sure the most accurate and timely information is available to you so stay tuned.

Now, back to the question at hand, “How is Health Care Reform going to impact the Music Business?” The music industry is a player among the nation’s largest industries, with an economic impact of $147 billion in 6 of America’s largest cities. Despite this percieved prosperity, an estimated 76 percent of music industry professionals have no access to group health benefits.* The percentage of those without adequate health insurance is significantly higher than the national average of uninsured individuals, and over 75 percent of those in the music industry with no health insurance say it is just too expensive to obtain without the availablity of group health care plans.** The lack of clear, factual information available to this industry regarding the implications of Health Care Reform has only increased the vulnerability of music professionals attempting to navigate these changes. This lack of access to affordable health insurance coupled with a lack of factual information about the Affordable Care Act will lead directly to poor healthcare outcomes, and unecessary fear and expense. Unfortunately, this has become a unique and perpetual cycle amongst the core industry demographic, our nation’s music makers, impacting the longevity of their careers and the vitality of our industry. It does not have to be this way!

According to Katherine Sebelius, US Secretary of Health & Human Services, the number one problem with the Affordable Care Act, or “Obamacare,” is the lack of education regarding the new law. Moreover, health care reform has become such a political football that the amount of misinformation circulating currently overwhelms the amount of accurate information available. Given the unique vulnerabilities of the music demographic, this lack of education and false information could be devestating for far too many in our industry. It can also be remedied. Healthcare Reform has the potential to be very helpful for many in the music industry if navigated properly. There is not a one-size-fits-all, but there are options for all demographics, some requiring a bit more creativity to piece together than others. There are also Federal and State subsidies that will become available in January 2014 to offset some of the costs, but taking adavantage of the opportunities afforded by the new law requires timely access to accurate information that is changing by the minute.

Here is what we know to be factual at this time:
• Young adults can stay on thir parent’s plan until their 26th Birthday – IMPLEMENTED 2010
• Kids under 19 can get coverage even if they have health conditions – IMPLEMENTED 2010
• All health insurance plans must cover 100% of certain preventative services with no-copays including colonscopies, mammograms and additional women’s preventative services IMPLEMENTED 2010 & 2012
• No more lifetime limits on the amount your health insurance will cover – IMPLEMENTED 2010
• Emergency room services are covered both in and out of network for the same amount – IMPLEMENTED 2010
• Your health insurance cannot be canceled unless you do not pay your bill – IMPLEMENTED 2010
• Relief for four million seniors who hit the Medicare Prescription Drug “Donut Hole” IMPLEMENTED 2010
• Everyone must have health insurance – DUE 1/1/2014
• Anyone can obtain health insurance regardless of health conditions – DUE 1/1/2014
• Health Insurance Plans are required to pay for a list of Essential Health Benefits that now include maternity, mental and behavioral health treatment
• Exchanges or online marketplaces to buy health insurance must open for business in each state beginning October 1, 2013 with effective dates of insurance coverage beginning January 1, 2014 and Exchanges will vary by state
• Open enrollment period for Exchanges will run from October 1, 2013 – March 31, 2014.
• Individuals and families with incomes up to 400% of Federal Poverty Level will qualify for subsidies meaning an individual can make up to $45,960 a year, family of 2 up to $62,040, family of 3 up to $78,120 and family of 4 up to 94,200 and receive help paying your monthly health insurance premium in the form of a tax credit – DUE 1/1/2014
• Cost Sharing subsidies will be available for those who are 100% – 250% of the Federal Poverty Level to help with high out of pocket medical expenses – DUE 1/1/2014
• Anyone who qualifies for subsidies IS REQUIRED to purchase health insurance through the exchanges to take advantage of this financial resource – DUE 1/1/2014
• If you chose not to get health insurance in 2014 you will receive a $95 tax penalty per adult and $47.50 per child up to a maximum penalty of $285 – December 31, 2014
• Americans who earn less than 133% of the poverty level (approximately $14,000 for an individual and $29,000 for a family of four) will be eligible to enroll in Medicaid. States will receive 100% federal funding for the first three years to support this expanded coverage, phasing to 90% federal funding in subsequent years – DUE 1/1/2014
• Plans on the Exchanges will be tiered with the top plan, Platinum, covers 90% of your health care expenses and you will pay 10% through a combination of known deductibles, copays and coinsurance. The plans range from Platinum (90% coverage), Gold (80% coverage), Silver (70% coverage), Bronze (60% coverage) and then a Catastrophic plan that is lower cost and has limited benefits (only available to those under 30).
• A Tax Return dated within the last 2 years must be submitted with your health insurance application on the Exchanges in order to qualify for a subsidy.
• Small Business Health Options Program (SHOP) has been delayed until 2015. There will be one option available through the Exchange throughout 2014.

Here’s what we do not know:
• How the COST of health insurance will be impacted?
• Who is responsible for what when it comes to the administration of all of the changes?
• How long can the state and federal budgets support the subsidies?
• What happens if the subsidy money runs out?
• Will there be a shortage of Primary Care Physicians?
• Why hasn’t the overall all cost of healthcare been addressed yet?

Music Health Alliance will be providing health care advocacy/navigation that assimilates factual and simplified information about Health Care Reform and distributes it in a readily understandable format, so we can empower music professionals to make better health care decisions, and increase their confidence in their ability to help themselves. This is also how our industry can protect itself from being unnecessarily exposed to the sales predators who are multiplying by the minute with false claims and savvy scare tactics motivated by profit. Our hope is that this will protect the industry from unecessary fear and cost, enable informed decision making that will result in better health care outcomes, and create an opportunity to change over time a negative cycle of poor health care coverage that has plagued the music industry for years.

So how is Health Care Reform going to impact the Music Business? It is hard to say exactly, however, MHA knows the facts of the law for every state, we understand music people because we are music people and we will be here to walk with you until we have answers and solutions to meet your individual health related needs. Music Health Alliance believes this will offer the best opportunity to create a favorable solution for the current health care challenges facing the music industry.

SPECIAL NOTE: MHA has taken the profit motive out of the health insurance and healthcare equation in order to provide the best solutions to the health related needs of the music industry. MHA is a nonprofit (501c3) with a program-centered budget, 84% of income goes directly to MHA programs and services. MHA’s operational expenses are supported by donations and fundraising events. All other MHA revenues go directly into the Cowboy Jack Clement Fund (Jack Pot) to provide music makers with financial relief from medical bills not covered by health insurance. Grants from the “Jack Pot” will begin in conjunction with the implementation of the Affordable Care Act, January 2014.

* SOURCE: Belmont University Study, Economic Impact Study compilation, US Census Bureau
** SOURCE: Future of Music Coalition

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Music Health Alliance is a non-profit organization providing the music industry with healthcare advocacy through health insurance, healthcare resources and confidential guidance.

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