A fascinating look at health insurance & the WGA/SAG-AFTRA strike

As the Writers Guild of America's ongoing strike enters its fifth month (and the Screen Actors Guild-American Federation of Television and Radio Artists, or SAG-AFTRA, approaches 50 days with their own strike for similar demands), Jackie Fortier has an interesting article at NPR about one of the less-discussed aspects which is often much higher profile in union strikes: Health insurance:

The health insurance offered by both unions is predicated on the notion that it is for members who work consistently and lucratively enough to make a minimum amount of money.

...the policy offered by the screenwriters guild, for instance, feels like a holdover from a bygone age. It has no monthly premiums, costs $600 per year to cover the rest of your immediate family and has deductibles that are in the hundreds – not thousands – of dollars.

This sounds pretty similar to ACA exchange coverage for enrollees who earn less than 150% of the Federal Poverty Line...or just barely enough to qualify for Medicaid via ACA expansion.

...Together [WGA & SAG-AFTRA] represent over 170,000 workers, who refuse to perform any part of their job after talks with studios and streamers stalled. Writers and actors could lose their eligibility for insurance simply because they aren't working while striking.

...For writers to qualify for health insurance, they must earn a little over $41,700 in covered union work a year and residuals don't count.

Ironically, this is the exact opposite of the zero-premium ACA coverage I note above: You have to earn more than a given threshold (roughly 285% FPL) in order to qualify for it. Huh.

...In contrast, residual payments do count toward the $26,000 per year that SAG-AFTRA members must earn to qualify for health insurance offered by the actors' union. This makes increasing residual payments especially from streamers like Netflix a high priority for members who are on the margins.

Plan premiums from SAG-AFTRA are $125 per month for union members.

$26K/year for a single adult is around 178% FPL; $125/mo is about 5.8% of that gross. By comparison, an ACA exchange enrollee earning that much would only have to pay roughly 1.1% (perhaps $24/month).

Members of both unions say it took them years to make enough money to qualify for the union health insurance, while other union members who have worked in the industry for years never have.

...All California workers who lose their employer-sponsored health insurance may be eligible for the state's Medicaid program, known as Medi-Cal, or qualify to buy health insurance through Covered California...

...Writers and actors who lose their union health insurance as a result of the strike could benefit from a new California law that took effect July 1, 2023 aimed at averting just that situation.

AB2530 received $2 million in funding under the new state budget. To qualify, a union worker must first lose coverage as a result of the strike.

Here's the official summary of the law in question:

This bill, upon appropriation by the Legislature, would require the Exchange to administer a program of financial assistance beginning July 1, 2023, to help Californians obtain and maintain health benefits through the Exchange if they lose employer-provided health care coverage as a result of a labor dispute. Under the bill, if specified eligibility requirements are met, an individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute would receive the same premium assistance and cost-sharing reductions as an individual with a household income of 138.1% of the federal poverty level, and, beginning January 1, 2024, would also not pay a deductible for any covered benefit if the standard benefit design for a household income of 138.1% of the federal poverty level has zero deductibles.

The "zero deductibles" part isn't actually limited to union members thanks to another policy enacted back in July which eliminates deductibles for any ACA exchange enrollee earning less than 250% FPL anyway. However, AB2530 was actually passed and signed into law last year, which I find kind of interesting; that suggests that it doesn't have any connection to these specific strikes but was passed to cover any union strike scenario which comes up.

In any event, since ACA enrollees earning less than 150% FPL pay nothing in premiums and have no deductibles, this is a damned good alternative for them. The only question I have is just how long their income would be treated as being 138.1% FPL for subsidy purposes under this law--the only language I see in the legislative text which addresses that is this:

(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollee’s employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.

OK, so the actor/writer/etc. is required to let the exchange know if their income increases (or decreases to the point they're eligible for Medicaid) or if their union health insurance gets reinstated...but it doesn't actually state under what circumstances the "treated as 138.1% FPL" status would end. Perhaps I'm missing something.

..."Covered California has seen fewer than 150 applicants who have identified an affiliation to WGA or SAG-AFTRA apply for coverage,"...they expect to see more if the strikes continue and people anticipating losing their union health insurance should get in touch.

This makes sense; it would take several months before most members would see enough of an income pinch to fall below the union threshold, and changing insurance policies is considered a pain in the ass for most people regardless of the circumstances.

...The new law doesn't cover crew members who are not part of the striking unions but have lost health insurance due to the work stoppage.

...The Union Solidarity Coalition known by the acronym TUSC has raised more than $315,000 to give assistance to International Alliance of Theatrical Stage Employees and Teamsters members, said founding member Alex Winter.

Alex Winter is probably best known to most people as Bill from the Bill & Ted movies, but he's also an accomplished actor, director, writer & producer outside of that, most recently for an acclaimed documentary about YouTube called The YouTube Effect.

I strongly encourage anyone interested in healthcare coverage, unions and/or the entertainment industry to read the entire piece.