Insurance on a Budget: A Look at Affordable Health Care in New York City - Budget Week


Photo by Images of Money.

Written by: Jennifer Smith

In modern day New York City, tales of the young, hopeless, and uninsured abound, crafting a narrative of perilous uncertainty; a place where the noble protagonist risks slipping through the cracks of a flawed system and succumbing to anxiety, sickness, and debt in the event of any unexpected catastrophe.

Collectively, the would-be heroes of these tales form “the young invincibles”—a hapless league who forgoes health insurance due to cost and instead employs a more ad hoc approach to wellness, namely, through the powers of Vitamin C packets, home stitches, and walking it off.

By day, they’re freelancers, part-timers, and in-betweeners who do their best to navigate around a precarious gap between the private insurance plans they can’t afford and the state/federal health insurance programs they aren’t quite poor enough to qualify for.

Their power doesn’t come from their ability to fall off a bike and deny themselves decent health care, but from their ability to share ideas, pool resources and effect change.

Of the 49.9 million uninsured Americans, 18-24 year olds were the only age group to see an increase in the percentage with health insurance from 2009 to 2010, which resulted in 500,000 fewer young adults without health insurance, according to a 2011 survey by the U.S Department of Health & Human Services.

Part of this decline is attributed to the Affordable Care Act, which stipulated that young adults could stay on their parent’s health insurance until they turn 26. Coupled with the rise of cooperative efforts in New York City and abroad, “the young invincibles” can now work with the government and community alike to further empower themselves and address the plight of the young and uninsured.

Freelancers Union: Protection Through “New Mutualism”

Image by Colin Dunn.

With independent workers’ preclusion from employer-provided benefits and freelancing becoming a bigger part of our economy, Freelancers Union provides the independent workforce with support, avenues for political action and even their own brand of health insurance.

“We can get people health insurance much less expensively and not be a part of the whole insurance world,” says Freelancers Union Founder and Executive Director Sara Horowitz. “There’s a whole new system where we can have economy, not just based on the short term return, but on achieving social goals that can be sustainable over time.”

Freelancers Union bases their approach on an idea coined “New Mutualism,” and cites other organizations such as Kickstarter and Etsy as fellow examples of the concept at work. Sharing and social networking take on an integral role at Freelancers Union, which not only helps with creating contracts, finding clients, and filing taxes, but also aims to connect freelancers with each other through events. This commitment to community has created a powerful advocacy machine that has already achieved some success in changing unfair practices surrounding the independent workforce.

“The New York government already recognized our model for freelancers. So freelancers in New York are in a better position than anywhere else in the country,” Horowitz says. “ That’s why younger freelancers can have options that others haven’t had.”

Those options include various health insurance plans that a freelancer can fit to their budget and a unique 40l (k) plan for independent workers. More than that, Freelancers Union tunes young freelancers into the policies that directly affect them. With the support of the Freelancers Union political action committee, newcomers have a chance to wield real power within the realm of policymaking.

“There used to be a tax for freelancers that we just got rid of,” Horowitz says of Freelancers Unions political gains.

In light of that success, the Freelancers Union turned its focus to payment protection with an act that would provide freelancers with some government protection and recourse should a client not pay them for their work.

“That’s going to legislature right now,” Horowitz says. “We need people to be active and work on that.”

Health Care Resources in The Community

Organizations all over the city share resources to provide the uninsured with affordable health care options. With some navigation of government and community initiatives, the young and uninsured can gather together a semblance of preventative care without breaking the budget.

New York City Free Clinic

The New York City Free Clinic, a partnership between the New York University School of Medicine and the Institute for Family Health, offers uninsured adults basic primary care, including disease screening, laboratory testing, vaccinations and more. Social workers are also on staff to help patients register for public health insurance programs.

Free STI Testing

The New York City Department of Health and Mental Hygiene provides several clinics for free and confidential testing. No appointment necessary.

Sliding Scale Hospitals

For emergencies, try to go to a hospital that operates on a sliding scale to ensure your visit caps off within a range you can afford.

BigAppleRx Discount Prescription Card

This printable discount card helps the uninsured save an average of 47 percent on prescriptions, according to the New York City Department of Health and Mental Hygiene.

Support Groups

For those looking to attend to their mental wellness, but can’t afford a psychologist.

For the Good of All

Image by Colin Dunn.

Although spending already overstretched dollars on health care pains many young workers who struggle to scrape by as is, it really is a noble cause and a much more sustainable approach to wellness than the aforementioned DIY methods.

From a practical standpoint, putting off necessary medical intervention only escalates the problem, and when the problem finally manifests itself, the treatment tends to be much more rigorous and expensive than it would have been with proper check-ups and preventative measures. Should an uninsured patient be unable to pay the bill as a result, the hospital will then have to recoup the cost.

More than that, putting off treatment in the hopes that the symptoms will subside could mean riding the subways with a potentially contagious infection.

Both of these consequences put strain on the community at large and considering the heightened role mutualism is beginning to play in society, the uninsured can’t afford to isolate themselves with their own brand of ad hoc health care, which does nothing to further their interests in health care reform. Instead, the young and uninsured within New York City can take advantage of the affordable resources available to them and ensure they remain available to others through sharing, support and advocacy.

Essentially, take care of yourself and take care of someone else.

Further Reading:

Healthy New York: another low-income insurance option.

New York City Health Insurance Link: an initiative of the Office of Citywide Health Insurance Access