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

If you are an artist or work for an arts organization, the following facts and figures may be useful for educating local officials, organizers, funders, and others in your 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 in U.S. communities.

• Roughly one in six individuals in the U.S. (16%), including artists (18%), is without any form of health insurance.^{1, 2}
• Most individuals in the U.S. who have health insurance have employer-sponsored coverage (roughly 67%).³
• Many artists do not follow traditional employment patterns. For example, U.S. artists are significantly more likely to be self-employed than others. In fact, more than one third of U.S. artists are self-employed, compared to less than 10 percent of the overall labor force.⁴
• Nontraditional employment patterns also place artists at greater risk for unemployment, particularly during our current period of economic struggle. Since the onset of the current economic downturn, the unemployment rate among artists has risen at a much greater pace than for U.S. workers as a whole. As of March 2009, artists were twice as likely to be unemployed than other professional workers.⁵
• 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.
• As of April 2008, more than one in six artists (18% or 300,000 individuals) was without any form of health insurance.⁶ And while further research is needed, it is likely that this number has risen considerably in light of the recent 63% increase in unemployment among artists, which occurred between the fourth quarters of 2007 and 2008.⁷
• As of April 2008, younger artists (ages 18-39) were much more likely to be uninsured than older artists, and lower-income artists (below 300% of the Federal Poverty Level) were three times more likely to be uninsured than higher-income artists (34% vs. 11%).⁸
• Roughly half of all artists (with health insurance) pay for their own health insurance, compared to a national average of under 10%.⁹
• The average premium for a health insurance policy purchased on the open market was roughly $4,000 for an individual in 2005. During the same period, the average premium amount paid by the employee with group coverage was only $1,655.^{10, 11}

Artists and Health Care:  Current Challenges and Opportunities

The appetite for health care reform in the U.S. is healthy. And with more and more dialogue about reform occurring at the national level, it is important to understand where artists are situated within the larger context of the current health care system in order to ensure that artists’ voices are heard and needs are met in decisions about reform.  Likewise, a better understanding of artists’ health care and health insurance challenges creates momentum to increase support programs and services that meet artists’ health-related needs at the local level. 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—roughly 67% of all Americans with health insurance obtain it through their employers (down from 75% in 2003).^{12, 13} 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.

According to the 2006 Current Population Survey there are 1.7 million people between the ages of 18 and 64 in the U.S. who consider their main profession to be artist. Out of this population 40% are self-employed (3.5 times the rate of other workers). Artists are also less likely to have full-year or full-time jobs than other workers—for example, artists frequently work independently for commercial and/or nonprofit organizations for short periods of time before moving on to new creative projects. Additionally, artists are more likely than others to work for smaller employers struggling most with the cost of providing insurance to employees.^{14, 15} 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.

It should be also noted that a common misconception is that artists who do not have coverage through an employer are able to obtain group coverage through a union. However, in this context, health insurance coverage is commonly offered only to those who consistently earn a majority of their income from their artistic work. This leaves out vast numbers of artists whose part-time work amounts to greater income sums. In the entertainment industry, for example, 70% of Screen Actors Guild members do not qualify for the union’s group health insurance. 

Professional artists have 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 here.

Cost

Employers typically have access to discounted health insurance plan group rates. This not only reduces costs for employers, but also for workers. 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 insurance¹⁶—and at much higher costs. Artists also pay a higher percentage of their income toward obtaining insurance than the general population. In 2005 the average premium paid by an employee with group coverage was only $1,655. In contrast, the average premium for a policy purchased in the individual market was more than double that at the rate of $3,664.¹⁷

Employers, and especially bigger employers, often pay a large percentage of premium costs—in 2003, the average contribution by employers with group health coverage for their workers was 82%.¹⁸ And while this number has likely declined significantly since 2003, the context for artists remains the same—at a disproportionate rate to the general population, artists not only face higher costs associated with individual plans themselves, but also lack the benefit of an employer’s contribution to offset that cost. At the same time, artists earn less on average than other individuals with comparable education and skill sets. 

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 here.

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 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 for the general public through lincnet.net. Please also visit our Connecting Artists to Health Care and Insurance Options section for free information resources that can be distributed to local artist networks throughout the U.S.

Need for Systemic Change 

Most agree that the current U.S. health care and insurance systems are financially unsustainable and on a course for eventual collapse. For American workers, this has meant bearing an increased burden in health care costs, and for artists, that burden is higher than average. Overall, from 1999 to 2006, health insurance premiums grew by an average of over 10% per year, compared to 3% per year average in inflation growth and a 3.5% per year average in wage growth.¹⁹ These pre-recession statistics become even more poignant in light of America’s recent economic downturn, but they also provide impetus for thinking about possibilities for changes at local and national levels. And with a new Presidential Administration in office, opportunities to implement reform efforts appear more imminent, and first steps are being taken.

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—23 countries have healthy life expectancies that are greater than that experienced in the United States.

• Average annual health insurance premiums for single and family coverage have skyrocketed over the past decade—between 1999 and 2008 premiums more than doubled—from $2,196 to $4,704 for single coverage, and from $5,791 to $12,680 for family coverage.²⁰

• While 2007 numbers show a moderate decrease in the number of uninsured individuals compared to 2006, the number of Americans without health insurance has increased over the past two decades—by roughly 14 million.²¹ And the current economic climate is likely to have refueled the overall trend of increasing numbers of uninsured Americans. The current number hovers around 46 million uninsured in the U.S.²²

• Despite a 2007 decrease in the number of uninsured Americans, rates of employer-sponsored coverage continued to drop. Currently, 59.3% of Americans are covered by employer-sponsored health insurance plans.²³

• A recent report from the Center for Studying Health System Change finds that of those who have health insurance, many still report unmet health needs.  Between 2003 and 2007, the proportion of people with insurance who reported unmet health needs rose sharply (at a rate of 62%) compared to that of uninsured individuals (33%). Cost was cited 90 percent of the time for people with no coverage, but also by more than 60 percent of people with insurance.²⁴Another recent study found that the number of adults (ages 19-64) considered "underinsured"—i.e. with coverage, but with very high medical expenses relative to their incomes—rose from 16 million to 25 million between 2003 and 2007.²⁵

Policymakers at the state and national levels have attempted to improve the health care system for nearly two decades. Still, Americans face a system that has gotten worse instead of better, and artists experience a disproportionate share of its burdens. Most past efforts to improve the system have happened at the state level, and in just the last few years. Following states like Massachusetts, more than 40 states attempted comprehensive changes, but now, with a new era of American leadership, the nation is poised for a higher level of action.