It’s a sad catch-22: the fact that dancers, whose bodies undergo some of the most intense physical stress of any members of the population, often don’t have the resources to give those bodies the specialized care they need. The army of freelance or “project” dancers who make up the majority of NYC’s performing force, in particular, face the daunting task of finding insurance through side jobs (keeping in mind that many employers don’t offer benefits to part-time employees), through their parents (an option for the young ones), or through President Obama’s dually lauded and critiqued resource: the Marketplace.
I surveyed thirty professionals in the field for this story. Of those thirty, twenty-one have health insurance coverage through their parents, indicating two things: 1. My sample group is young (under the Affordable Care Act, offspring can stay on a parent’s plan until age 26), and 2. Depending on the terms of that plan and the parent’s place of residence, these twenty-one individuals may or may not be covered by their insurance in the state of New York, which could require them to travel out of state in order to seek medical treatment.
One out of thirty is uninsured and has been since shortly after his 26th birthday; he stated that during this time, he’s been mindful of how he’s cared for everything from a cold to an injury. In 2012, he was called “a captivating performer, a formidable dancer who is also capable of carefully modulated expressions” in a New Yorker review. By my count, that was the year he lost his insurance.
Eleven out of thirty have turned down or prematurely ended physical therapy or other treatments and preventive care for injuries because of prohibitive cost – seven of those eleven cite this issue even though they are covered through their parents, whose family plans are presumably more robust than the catastrophic individual plan that might be chosen by someone whose priority is a low monthly payment (twelve out of thirty ranked this as their first priority in selecting a plan). Catastrophic plans, which cover almost nothing other than three physicals per year, are available to those under the age of 30 and those who qualify for a hardship exemption based on poverty level.
Rehabilitative services such as physical therapy are one of ten “Essential Health Benefits” that must be offered as part of every plan under the Affordable Care Act (other essentials include emergency services, mental health services, and prescription drugs), meaning that every plan offers access to physical therapy. However, not every plan will offer the same cost-sharing benefits. A catastrophic plan, for example, will not share the cost of PT until you’ve spent your full deductible – often several thousand dollars – in out-of-pocket payments. So, while an individual with a low income may qualify for a catastrophic plan with an incredibly low (even free) monthly payment, that same person may wind up spending so much on physical therapy appointments, prescriptions, and other treatments that a catastrophic plan doesn’t cover that a bronze or silver plan with a higher monthly payment could still be a more affordable choice.
So, how do you finance a higher monthly payment? First: that payment is calculated based on income. Applicants whose annual income falls below a certain level are eligible for Advance Premium Tax Credits (APTCs), which can significantly reduce the monthly payment owed. A very low annual income can also shrink a plan’s deductible, meaning fewer co-pays before insurance kicks in and covers the full cost.
Last month, I enrolled in a silver plan through Healthfirst. Based on my income, I was eligible for a $233.00 APTC, which means that my monthly payment for a plan with reasonable co-pays, gym membership reimbursement, over 24,000 providers to choose from, and $10 generic drugs, is $167.37.
All of this makes me happy and hopeful, but I don’t think it’s enough. $167.37 sounds manageable to me, but it’s probably not feasible for some of my peers. (I have two part-time non-performance jobs.) We have to do better. One person I surveyed receives insurance through the American Guild of Musical Artists (AGMA) as a member of Ballet Hispanico, one of fewer than thirty dance companies from across the country that AGMA represents. Should AGMA open its doors to the hundreds of other “men and women who create America’s operatic, choral and dance heritage*”? Should there be additional monthly credits available for movement artists, who have an oft-undeserved reputation for dramatic injury when in fact we tend to be healthier and more physically fit than office workers whose sedentary lifestyles may pose greater long-term health issues? A program like this would bring its own issues: how would the Marketplace determine who is qualified for such a credit? What defines individuals as dancers, especially if they don’t earn the majority of their income as such?
Now that the Marketplace is in its second year and its initial kinks have been worked out, it’s time to begin addressing the gaps. Let’s write down what we think we need and share it with our colleagues. Let’s circulate our arguments and wish lists and pitches. One of the challenges in defining a single solution to our community’s healthcare problem is the fact that every dancer’s experience and structure is different. So let’s get as many perspectives as we can to see the biggest possible picture.
What do you want your healthcare to look like?
Remember when doing annual income calculations that dancers who can verify their earning status as performers are eligible for special tax write-offs – but that’s literally another story. Stay tuned for an article on making the most of your taxes this year)!
* statement from AGMA’s official website