College Graduate,Family Support, the Individual Market (before healthcare reform), Job with Benefits


(Interview 11/ 2010. Oil on linen, 40 ins. x 30 ins.)


Update 2021

I remember this subject telling me she wasn't sure the portraits looked like her. Many of my subjects have a hard time seeing themselves in their portraits. She asked her friends if the portraits looked like her. They said, "Oh yeah!"


I go for the sitter's vibe. I want the person I'm interviewing to look back at me from the canvas. I have said, "I don't paint pretty pictures. I paint souls." I certainly do not object to pretty pictures. I just never think about making a painting pretty (except once when I felt a subject was in a very fragile place).


I want to feel the subjects more than manipulate an image to make some version of pretty that I think might please somebody. Does second-guessing ever work? All the twisting-in-knots and zigzagging to make or do something we think will please someone or improve our lives... Isn't disappointment often the sequel after the effort?


When I returned to art-making 25 years after I had put in a year in my early twenties, I was old enough not to give a damn about control. Yes, I would learn oil painting's mechanics. How does the brush move the paint? How to mix colors? What medium to use? How to clean the brushes? How to sight measure? But I was not going to bully my painting into how it should look. I was going to let the painting unfurl...and surprise and delight me like the Rockefeller Center Christmas tree.



This subject represents a young person starting her career, working part time jobs, piecing together health insurance, and finally getting employer-sponsored health insurance when she landed a full time journalist job. (Employers are not required to provide health insurance to part time employees even if they do so for their full time employees.)


All young people did not have the family support and a track to a full time job with health insurance coverage. In 2010 34% of young adults aged 19-25 were uninsured -- 10 million people. This age group could stay on their parents' health plans if they were in college. But once graduated, these young adults often had to fend for themselves. Some, like this subject, managed to to avoid a lapse in coverage.


Courtney, another subject in this project, died trying to save a little money by cutting back on her insulin. After graduating college she did not have a job with health benefits, and she could no longer stay on her parent's insurance policy. Courtney was uninsured. It was cheaper for her to buy her own insulin supplies than pay a higher insurance premium because she had Type 1 diabetes, a preexisting condition.


The Affordable Care Act (ACA) no longer allows insurers to consider a person's medical history when selling insurance. The ACA also permits adult children to stay on their parents' health plan until age 26.

.

 

A study. Oil on canvas, 24 ins. x 20 ins.)

(From a 2010 interview)

Newspaper Reporter, Insured, Age 43


When the subject was 20 years old, she sought treatment for a female medical problem. Her parent's health insurance covered her care. She was listed as a dependent on her parents’ group health plan, insurance provided by an employer.


The subject graduated college in 1990. After college she worked two part-time jobs and lived at home. As a part-time employee, she was ineligible for health benefits from either of her employers even though her combined hours totaled a full time work week


From 1990-1992 the subject paid $400/month for an insurance policy on the individual market. (GOOD LORD, that's $829.29 in 2021 dollars. Was she was charged more because her medical records reported her prior medical problem? Probably.) She does not know if the high premium in 1990 for a 23 year old was due to a previous medical problem being characterized as a pre-existing condition. The subject's parents managed the insurance forms. The subject paid the premiums.


Before 2014, insurers could charge individuals needing a single policy a higher premium, or not sell them insurance at all, if they did not like what they found in the person's medical records.


In the fall of 1992, the subject got a full-time job as a newspaper reporter. The full-time job came with health insurance benefits. The policy required a 90 day waiting period before benefits would start. The subject's part-time work with the company now employing her full time satisfied the waiting period requirement.


Today (2011) the subject pays $165/month, 35% of the premium. Her employer contributes $305/month.


The subject's employer is self-insured meaning the employer keeps the premium dollars then pays her employee claims from those funds. Most employees may not know their large employers are paying their medical claims. The employees have insurance cards issued by commercial insurance carriers that have become household names. Companies like Independence Blue Cross are acting as third-party administrators for the employers, for example. A third-party administrator supports self-insured companies by providing administrative services for the health plan -- enrollment, claims processing, record keeping and more.


Many of the Affordable Care Act's consumer protections apply to self-insured health plans but not all. Nevertheless, companies large enough to self-insure usually offer good to generous health insurance packages to attract talent.


The subject pays a $20 co-pay for all doctors and $100 co-pay per emergency room visit. Her policy has a $1,000 out-of-pocket charge for some services like diagnostic testing and EKGs. She uses coverage for check-ups twice a year.


The subject would not consider switching to a cheaper policy. Her employer offered a high deductible health plan (HDHP), a policy where the insured pays thousands of her own medical expenses before the insurer starts paying her medical claims. The subject decided that, "Forking out the money first was too much of a burden and then I'd have to do the paperwork."