What You Need to Know: Useful Facts about Artists & Health Care

Artists are not the only workers with challenging health care issues, but there are characteristics of many artistic careers that make artists especially likely to fall through the cracks of the current health care system. In many ways, artists are an “at-risk” population with regard to health insurance coverage, given the realities of their careers.

Nontraditional employment patterns coupled with the dominance of employer-sponsored coverage in the U.S. results in higher than average health-related costs for artists. The following statistics may be useful for artists and arts organizations in educating local officials, organizers, funders, and others in the community about artists’ health care and health insurance needs. With deeper knowledge of the context in which artists maneuver within our current health care system, the potential exists to ignite greater support for health care and health insurance-related programs for artists across the country. 

  • Approximately one in six individuals in the U.S. is without any form of health insurance. 1,2
  • According to a 2010 Census data report, this number increased almost 10% between 2008 (46.3 million) and 2009 (50.7 million).
  • The majority (63%) of individuals in the U.S. who do have health insurance have employer-sponsored coverage. 3
  • But many artists follow nontraditional employment patterns. For example, U.S. artists are significantly more likely to be self-employed than other workers, and to purchase their own insurance in the individual market. 
  • In addition to their premiums, individuals who purchase their own insurance also have fairly high deductibles, averaging $5,149 per year for families. 4
  • Nontraditional employment patterns also place artists at greater risk for unemployment, particularly during periods of national economic struggle. As of March 2009, artists were twice as likely to be unemployed than other workers. 5 

Artists and Health Care:  Current Challenges and Opportunities

In 2010, LINC commissioned a report exploring the adequacy of health insurance for U.S. artists under current policies, and the implications of the Patient Protection and Affordable Care Act (PPACA) on artists’ future prospects for health care coverage. The findings summarized here are based on analysis of more than 5,300 responses to an online survey for artists conducted by LINC in the summer of 2009. Download the full report on this survey.

The career patterns and job profiles of U.S. artists, coupled with current health care policies and practices, currently put adequate health insurance beyond the reach of the majority of working artists. When fully implemented, the PPACA will lower many of the barriers that currently prevent artists from securing adequate health care insurance. Many artists’ service organizations are working creatively to expand current coverage and ensure that artists’ interests are addressed under the PPACA. 

As the regulations to guide implementation of the new legislation are developed over the coming years, artists and those concerned with their welfare have an opportunity to work collaboratively to ensure that artists’ voices are heard and needs are met in the new system. Below are some particular challenges to consider in addressing artists’ health care and health insurance needs. 

Employment Patterns 

The U.S. health care and insurance system is structured based on employer-sponsored group coverage—most people in the U.S. under the age of 65 get their health insurance through an employer, making it the most common form of health coverage.6 This system creates formidable challenges for large numbers of self-employed and part-time workers, including many artists, who must navigate the open market to find individual health coverage.

About 60 percent of artists and related workers are self-employed7. Artists are also less likely to have full-year or full-time jobs than other workers, earn less, and are more likely to work for smaller employers struggling most with the cost of providing insurance to their employees. Workers in firms with many lower-wage workers contribute a greater percentage of the premium costs than those in firms with fewer lower-wage workers (24% vs. 18%)4.

It should also be noted that despite popular misconception, the vast number of artists who do not consistently earn the majority of their income from artistic work are unable to obtain group coverage through a union. In the entertainment industry, for example, 70% of Screen Actors Guild members do not qualify for the union’s group health insurance.

With most artists having at least some of these employment characteristics, artists find themselves outside the mainstream of the current U.S. health insurance system, creating circumstances for inconsistent coverage and resulting in fewer and more expensive options than those available in the traditional employment sector. There is a particular need for sources of reliable information about affordable health care and health insurance options available locally and on the open market. LINC is committed to providing artists with greater opportunities to acquire better information about health care and health insurance options in their local communities. Learn more about LINC’s resources.

Cost

Artists not only lack employer contributions to their health insurance at a disproportionate rate to the general population, but they are also facing higher costs associated with their individual insurance, while earning less than other independent workers with comparable education and skill sets: 

  • Employers typically have access to discounted health insurance plan group rates. This not only reduces costs for employers, but for workers as well.
  • However, artists’ employment patterns make it less likely for them to obtain employer-sponsored coverage.
  • Accordingly, artists are twice as likely as the general population (11% vs. 5%) to purchase their own health insurance8, and at much higher costs. 
  • In 2010, the average premium paid for a policy purchased in the individual market was slightly below that of employee-sponsored coverage ($3,606 vs. $3,997). However, in addition to their premiums, individual purchasers report an average deductible of nearly $2,500. One in four has annual deductibles of $5,000 or more.3
  • As self-employed purchasers, artists also pay a higher percentage of their income toward obtaining insurance than the general population. 

While individual health insurance plans are often costly, it is important for artists and for anyone seeking quality health care and/or health insurance to have access to reliable information about affordable options for themselves and their families. Learn more about accessing affordable health care options.

Access to Information

Information about how individuals can obtain affordable, quality health care and insurance can be extremely difficult to find, navigate, and interpret – especially without the support of an established HR department. Resources for individuals are not often widely promoted or integrated, as they come from a variety of sources, such as charitable organizations, government agencies, community groups, unions, and associations. LINC promotes access to information about health care resources for artists, and provides useful resources and tools for organizations that work directly with artists in local communities. LINC also commissions research to gain a better understanding of the conditions artists face when making decisions about health care and insurance. 

LINC-commissioned research is available to the general public through lincnet.net. Please also visit our Every Artist Insured by 2014 section for free information resources that can be distributed to local artist networks throughout the U.S.

Systemic Change 

Most agree that the current U.S. health care and insurance systems are financially unsustainable. The average annual family premium in 2010 is 27% higher than the average family premium in 2005, and 114% higher than the average family premium in 20003. For artists, that burden is even higher than average. These statistics become especially poignant in light of the Recession, but they also provide impetus for thinking about possibilities for changes at local and national levels. Additional figures shed light on the magnitude of the current problem and the need for systemic changes:

  • Despite the fact that the U.S. spends much more per capita than other industrialized nations, our health outcomes are worse—the United States currently ranks 50th in life expectancy.9
  • The number of uninsured Americans rose by 4.4 million to 50.7 million last year, the largest annual jump since the government began collecting comparable data in 1987, according to the Census Bureau.10
  • In 2010, 38% of large employers reduced the scope of benefits and 36% increased their workers premium share in response to the poor economy.3

With the passage of the Patient Protection and Affordable Care Act (PPACA), attention now shifts to the regulatory level, and setting the rules and policies that will govern the implementation of the law and establish the state exchanges. There is room for wide interpretation of the law in many areas. Who implements the provisions, how, and at what cost are questions yet to be answered, and may differ widely state by state, as there is no standard process for implementation and several legal challenges currently underway.

There are many unknowns and the situation will continue to change as the law is implemented in its various stages and locations. Reliable and up-to-date information is critical for individuals and small business owners wanting to know what this means for them, as well as for advocates and service organizations seeking to provide advice and assistance to artists and small nonprofit arts organizations. Please visit Every Artist Insured by 2014 for more information. 

1Dineley Johnson, Teddi. “Census Bureau: Number of U.S. Uninsured Rises to 47 Million Americans Uninsured: Almost 5 Percent Increase Since 2005.” Medscape, January 8, 2008: http://www.medscape.com/viewarticle/567737 [accessed March 23, 2009].

2Lavarreda, Shana Alex, E. Richard Brown, UCLA Center for Health Policy Research, Health Insurance Among Working Artists in the United States (UCLA: April 2008).

3Kaiser Family Foundation and Health Research and Educational Trust. 2010 Kaiser/HRET employer health benefits survey. (Menlo Park, CA and Chicago, IL: 2010)

4Kaiser Family Foundation, Survey of People Who Purchase Their Own Insurance, April 2010

5National Endowment for the Arts, Artists in a Year of Recession: Impact on Jobs in 2008 (Washington, DC: NEA, March 2009).

6Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured, The Uninsured: A Primer, October 2009

7Bureau of Labor Statistics, Occupational Outlook Handbook, 2010-11 Edition

8Lavarreda, Shana Alex, E. Richard Brown, UCLA Center for Health Policy Research, Health Insurance Among Working Artists in the United States (UCLA: April 2008).

9Central Intelligence Agency (2011). The World Factbook. Retrieved May 14, 2011

10U.S. Census Bureau, Statistical Abstract of the United States: 2011 (130th Edition) Washington, DC, 2010