From time to time I will post a picture of a portrait and share what I have learned. I must often research what my subjects tell me because I don’t understand their predicaments. I painted this portrait of a punk rock singer/sports coach in 2010. Two years later, I look back and reflect. (There’s a nifty tool from Kaiser Health Foundation, an online calculator, to help you determine if your income qualifies you for a subsidy to help you pay for insurance if you work but can’t afford insurance. I’m jumping ahead but nevertheless…)
I was drawn to this story because I wondered how is it that we positioned ourselves as a society where a young musician who supports herself by coaching sports teams at an expensive private school does not have the means to get or access to health insurance? How is this possible in a first-world country? Is she doing something “wrong?”
I had already been painting stories for over a year at this point. I interviewed this subject just a couple of months after the Affordable Care Act a.k.a. Obamacare was passed. I didn’t understand what the law would mean. My focus had been on just telling the stories of real people – not really knowing where it would lead but sensing that we had really better start telling the truth because Americans were suffering.
In fact, after Obamacare passed I thought I would wind down the project. I thought the nation had taken a first big step toward addressing the problem of lack of access to medical care for many millions.
But the vociferous opposition to Obamacare compelled me to research the law fully. Two years later I have come to understand what the law would do for this woman.
This subject is an individual who does not get insurance through her job. She is considered a part-time employee. She would shop for insurance on the new online marketplace in her state in 2014. This marketplace houses many different private companies selling all types of policies. For companies to sell in this new marketplace, they must agree to certain rules like they can’t exclude people with pre-existing conditions. But PRIVATE companies are selling the insurance, NOT the government.
A subsidy is a way for a person to take responsibility for her healthcare and purchase health insurance. This subject would never pay more than 2% – 9.5% of her income for her insurance premiums on the online insurance marketplaces depending on how much she earns. Her income puts her in the range of wages that qualify her for subsidies, a form of financial aid. If she made about $25,000/year she’d pay about $144/month. Here is an online calculator to figure out if you qualify for a subsidy to help you pay for health insurance.
Why do we want this? When people don’t have insurance it’s usually because they can’t afford it. They put off primary care and treatments that could stave off larger more expensive illnesses to treat. They might end up in emergency rooms, get whopping bills they can never pay. They then have medical debt that can bankrupt them. Doctors and hospitals aren’t getting paid for services rendered. Uncompensated care ends up in higher premiums for people and employers who do pay. When people don’t have insurance, it’s bad for everybody.
The subsidies are for people who are NOT getting insurance through a job and whose wages qualify them. The uninsured pay their share, get a subsidy and now have insurance when they need to access care. The marketplaces and subsidies do not start until 2014
Here is the original story for the portrait:
Punk Rock Singer, Part-Time Sports Coach (basketball, soccer, softball) for Girls’ Teams at a Private School in a Large City, Age 28, Uninsured: Subject has no health problems but realizes she’s getting older and her body is changing.
She has gone to a dental school for dental care. Subject does not get regular check-ups but has made a commitment to gynecological care through a non-profit organization.
Subject is waiting to earn enough money to be able to consistently pay monthly health insurance premiums. (Interview May 2010) (oil on canvas 40 x 30 in.)