AHIRC’s Renata Marinaro Speaks To New York’s City Council
On January 23, The Actors Fund‘s Renata Marinaro, Director of Health Services/Eastern Region for The Artists’ Health Insurance Resource Center (AHIRC), testified to the New York City Council Committee on Cultural Affairs on increasing health insurance access for artists in the city. The Committee is considering various ways to increase access to health care and insurance, including expanding bartering programs such as Artists Access and targeting information and resources at the creative community. Council members present included James Van Bramer and Dominic Recchia, who were joined by Commissioner of the Department of Cultural Affairs Kate Levin. The Commissioner and the Chair of the Committee recognized The Actors Fund’s central role in educating artists on health care options and providing free care through the Al Hirschfeld Free Health Clinic.
Renata’s testimony was so enlightening and included so many important points, we thought we’d make the transcript available to everyone:
My name is Renata Marinaro. I’m the Director of Health Services, Eastern Region, for The Actors Fund.
THE ACTORS FUND is a national human services organization that helps all professionals in performing arts and entertainment. THE FUND IS A SAFETY NET, PROVIDING PROGRAMS AND SERVICES FOR THOSE WHO ARE IN NEED, CRISIS OR TRANSITION. Founded in 1882, The Fund serves those in film, theater, television, music, opera, and dance, and assists both performers and those behind the scenes with a broad spectrum of programs designed to address the needs of the community, including comprehensive social services, health services, supportive and affordable housing, employment and training services, and skilled nursing and assisted living care. The Fund also makes emergency grants for essential needs.
In 1998, The Actors Fund received grants from the National Endowment for the Arts to create a resource center for uninsured people in the visual and performing arts. This was in response to the high number of uninsured and underinsured artists — estimated in 2009 by Leveraging Investments in Creativity to be 36%, higher than the general population estimate of 25%. The Fund created an online state-by-state database, accessible for free at www.ahirc.org, that links to up-to-date information about getting and keeping health insurance and finding quality, affordable health care for those who cannot afford health insurance or do not have access to it because of a pre-existing condition. The website received about 348,500 individual visits in 2011.
In addition, counselors at the resource center advise entertainment industry professionals in person and by phone regarding their options for getting health insurance. Clients are educated on a variety of options, including private insurance — unaffordable to most artists since premiums for basic HMOs currently range between $920 (the cheapest) to $2765 per month — to association plans for the self-employed, like The Freelancers Union or TEIGIT, where the cost is still high but less than half of the private plans, to income-based government-subsidized programs, like Medicaid, Family Health Plus, and Healthy NY.
We counsel over 3000 artists each year, many of whom cannot afford any of these options, and, among the performers, do not get enough union work to qualify for benefits with SAG, AFTRA, Equity or the Musician’s Union Local 802. While some will not need medical care during the year, others will be among those who avoid or delay needed care, or who get care and are charged exorbitant non-negotiated rates, then face medical bills of thousands and even tens of thousands of dollars that, despite the financial assistance we can offer, cause them to go into ruinous debt.
New York City is fortunate to have excellent community clinics such as the Ryan Centers and Callen-Lorde that charge on a sliding scale and are a medical home for many artists. The Actors Fund operates the only full-time free clinic in the city, the Al Hirschfeld on 57th St and Tenth Avenue. Last year the clinic saw almost 1400 uninsured patients for almost 3,000 visits. In addition, the city’s Health and Hospital’s Corporation’s HHC Options program provides hospital care to the uninsured based on their income. But these are not a substitute for health insurance.
Since The Actors Fund last testified in 2009 the health insurance landscape has changed, losing some features and gaining others. The arts service organization Fractured Atlas no longer offers health insurance. The Freelancers Union coverage has gotten more expensive with higher deductibles and co-pays, and Healthy NY, a program heavily utilized by our community, now offers only high-deductible plans, making it a less attractive option for many who need regular care. The ARRA subsidy allowed many of our clients to continue their coverage at affordable rates; however, it expired in 2011. Fortunately, the New York State Entertainment Industry COBRA subsidy, which began in January 2005, has survived and continues to help industry professionals bridge periods of low employment.
These losses, however, have been compensated for by the Patient Protection and Affordable Care Act. It has brought welcome and necessary changes to the system: younger artists can now be insured under their parents’ coverage up to age 26, a benefit that has been heavily utilized. The NY Bridge Plan has been a lifeline to many formerly uninsured artists who, without it, would be forced to pay more than double the cost of the Bridge Plan premium for insurance that would not cover their pre-existing conditions for at least a year. And for the senior performers, the 50% discount on brand name drugs in the doughnut hole has made a big difference.
And what is coming in 2014 will have an even greater impact on our community. The ability to purchase a comprehensive health insurance plan that meets an individual’s or a family’s health care needs on a competitive Exchange, the system of subsidies to make it affordable to low and middle income people, and the mandate to purchase insurance has the potential of finally achieving our mission of EVERY ARTIST INSURED.
New York has more health insurance resources for performing artists than most other states, yet the number of uninsured in the performing arts remains high. Episodic work and low and/or infrequent pay make it difficult for performing artists to maintain health insurance and find affordable health care. To repeat: the most positive change to the health care landscape for the entertainment and arts community has come from the Patient Protection and Affordable Care Act, many of whose provisions are directed at the individual and small group market, where the majority of artists find themselves.
The Actors Fund’s Artists Health Insurance Resource Center (AHIRC) has been connecting artists, craftspeople and entertainment industry workers around the country to health insurance and affordable health care since 1998. For more information, visit www.actorsfund.org or www.ahirc.org.
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