An ACA Repeal Could Be Devastating for Freelancers and Entrepreneurs

With President Trump’s inauguration came big plans to repeal the Affordable Care Act — also known as the ACA or Obamacare. Last week, the Republican-majority Senate moved toward this end when they revealed a bill that would reduce Medicaid and end Obamacare’s mandate that all Americans are covered by health insurance.

Obamacare has been a controversial — and, frankly, flawed — health care solution from the get-go. Still, many worry that this legislation will upend both the healthcare marketplace and the Medicaid program, placing a strain on states and providers. Then there’s the devastating effect the repeal will inflict on individuals currently covered by Obamacare — one whose potential repercussions have even been called out by the Association of American Medical Colleges.

Though those with pre-existing conditions will take a big hit, so will the self-employed — particularly those who dropped private coverage when Obama signed the ACA in 2010. As the bustling gig economy continues to grow — as of 2017, the US alone has more than 55 million freelancers — more and more entrepreneurs will have to choose between self-employment and health insurance benefits.

Sarah Dolislager, a 27-year-old consulting firm owner, left her job with the state of California in 2014 after she was confronted with unexpected health issues. The possibility of Obamacare gave her confidence to pursue freelance work in place of her salaried position, even though she would lose her benefits. When Dolislager and her husband, who had previously been covered by his insurance, transitioned careers again in early 2016, they opted for Obamacare.

“We began purchasing our own insurance on January 1, 2016 when I was about six weeks pregnant. The insurance broker we worked with helped us figure out that our income was just above the cap for subsidies for a family of two but that pregnancy was not a pre-existing condition, so we had plenty of options,” Dolislager said. “Since I was able to purchase health insurance in my first trimester I received the care I wanted from the practice I desired,” she said.

Now, with health care premiums and options in limbo, Dolislager isn’t sure what’s next. Add two more pre-existing conditions into the equation — not to mention the couple’s desire to have another child — and ample coverage seems like a distant dream.

“I don’t think it’s right that we may decide to not have another child if it will cost us more than $30,000 without insurance. We work hard, pay taxes, and currently pay for our own insurance without subsidies,” she said. “Does this not fit the bill for the lawmakers who are repealing the ACA? What else do we need to do?”

Dolislager also worries about her ability to purchase insurance given the fluctuation of her contract work. “I currently have a contract that provides enough for my family, but if ACA is repealed and my contract does not get renewed or the provisions change, I worry about our ability to purchase insurance,” she said.

“If any of my family members gets sick, we could be facing health bills that would bankrupt us without the ACA. Thankfully that’s not our reality at the moment, but it is the reality for many Americans, and that’s enough for me to know that a repeal of the ACA is not the right answer.”

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(Photos via Getty)