Hacker News Reader

Comment by afarrell | Hacker News Reader

> many of these taxpayers do not have access to the traditional social safety net, such as unemployment insurance, or access to health care they can afford.

1) Doesn't the availability of freelance work act as a safety rope for people who lose their full-time work or find it hard to get due to schedule constraints and/or criminal convictions?

2) The ACA was supposed to make health care affordable for freelancers. Is it in fact failing to achieve that for most people? I remember feeling like the cost of procedures was on a silver plan too far uncertain and moved to the UK partly for that reason.

View on HN

Healthcare is still incredibly expensive for freelancers. ACA hasn't lowered costs the way it was intended to, but it has required that people who previously went without insurance (because they couldn't afford it) purchase it.

Depending on your political persuasion, this is either because 1) ACA didn't go far enough and was de-fanged before birth or 2) it was a bad idea and we should have gone in a different direction.

Healthcare is getting more expensive faster than inflation. ACA did lower costs when you account for this long term trend. But, not if you compare costs now vs 5 years ago.

ACA addresses healthcare INSURANCE costs, not actual healthcare costs.

Since the probability that a person will need healthcare and thus utilize their health insurance, is basically 100%, increasing healthcare costs will necessitate increasing health insurance costs.

ACA was simply a way to get healthcare costs to be spread out among more people by forcing them into the insurance pool, which was more politically viable than the option where all taxpayers pay for each other's healthcare (taxpayer funded healthcare).

The majority of the ACA addresses healthcare insurance costs. But the ACA is a very large piece of legislation and some pieces were intended to reduce healthcare costs.

Then they should have called it the Affordable insurance act.

What the ACA did and was intended to do (as a first order effect) was provide reliable provision of insurance for those not tied to an employer. The pre-Aca system was riven with stories of people with (eg) diabetes losing their jobs under completely ordinary circumstances, and then finding themselves unable to get insurance anywhere. The ACA closed this gap, and most of its most famous provisions are based entirely around this. I don't even necessarily think it's a great law, I just hate misinformation.

For young, healthy freelancers it raised costs even relative to trend, because prices had to flatten and accommodate the higher cost folks who would've been excluded due to existing health conditions. But afaict this isn't true in general.

I'm not sure you're even disagreeing with the parent. Personally, I think that pre-existing conditions/inability to be insured as an individual could have been handled in a much less painful and politically fraught way.

But the parent is basically complaining that health insurance is still expensive for someone on a limited budget who isn't covered by a company. And it is. Because healthcare is expensive for the population average. (As, for comparable levels of care, it is everywhere even if it's arguably more expensive than it should be in the US for various reasons.)

The big difference for me at the time I was freelance was that there was actually a point to getting insurance. Pre-ACA if I got a serious mid to long term illness my insurance company would just drop me anyway. Although once ACA was enacted it was still kind of pointless in that the deductible put me in a position where unless I got a mid to long term illness I'd never use it. So in reality I just went without and planned to just declare bankruptcy if anything bad happened. Bonus of the new ACA era is that I could just wait for open enrollment(hopefully I would get really sick at the right time of year) and pick up a gold/platinum plan if I did end up with something that required long term care.

I took a sabbatical for the last ~year and a half and the only reason I wanted insurance was on the off chance I got hit by a car and ended up with some catastrophically high bill. My deductible is something like 8000 dollars but I'd rather pay that than have to absorb 100,000 after an accident.

If it raises mandatory costs for all freelancers, doesn't it effectively equalize freelancer rates across the market? So insured freelancers don't have to compete with other freelancers that save costs by going without health insurance.

Reply on news.ycombinator.com