70 Comments

As a Canadian, I don't need it. But I certainly do applaud it. Back when I was a freelancer for the LA Times my editor was looking to leave the paper. What she wanted to do more than anything was be a freelance editor, but she ended up taking a job with a magazine because of the health insurance. One thing that has often mystified me about the alleged "land of opportunity" is how the fear of losing health insurance keeps so many people in jobs they hate or prevents them from fulfilling their career dreams.

If health insurance was something I had to worry about, I'm not sure I'd have become an author. I am happy to be on a platform that is so thoughtful in helping their writers be successful. This sounds like a true win-win. Bravo!

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... it's good marketing ... but it doesn't change the affordability math one iota - and the math here in the U.S. is brutal. Using this online "tool" (that Substack is "partnered" with), an "Expanded Bronze" HMO plan for a family of 4 is over $5,300 - per year (here in Arizona - states will vary somewhat). BUT ... and here's the kicker ... that Expanded Bronze plan has a $16,000 deductible! Anyone can use the online tool - so it begs the question - what exactly is the Substack "partnership?" Basically - it's a link to a website - which I wouldn't categorize as a "partnership."

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Thanks for sharing, James. 🙌🙌

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This is such a ridiculously good thing to do. So many of my US friends have been through hell with their health insurance so I know how grim it can be (I'm a Brit so this doesn't apply to me). So - yeah, this is amazing. You're doing a terrific thing here.

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Thanks for the note, Mike 🙌. We're looking forward to learning from this program and building support services out further!

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Hamish, what a great idea. Substack is seriously altering not just the media and writing status quo, as we see from the latest round of attacks against you, but seriously disrupting the nation's train of thought on so many fronts.

Keep it up!

Ric

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Another Canadian here... but my partner is American, so I am too aware of how desperate it can be South. There's a thoughtfulness here, yes, and I appreciate that and am glad to be onboard.

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Whoa! You guys are embracing and experimenting with some really great opportunities here. 😮❤️ So great!

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❤️ Yes! We're excited to continue testing, iterating on, and expanding these support services. Thanks, Gail.

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You bet! My experience here has been fantastic. Thank you for creating and maintaining this space.

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I'm not among those who need this, but I'm so glad to see you've pulled it off. I took my current job in large part because the ACA had made it too expensive to insure my kid on the open market. That's what forced me out of freelance work.

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Hi Substack team, I want to offer a little feedback on your health plan support. I think it's great you're trying to help writers with health insurance, but please know that a one-time stipend of $500 is like giving a starving person who hasn't eaten for two days $1 for a meal. It's basically pointless. An individual health plan with a $6,000 deductible is still around $350/month (or more). A one-time stipend of $500 will cover a month-and-a-half of premiums, but nothing else. Reading that doesn't even begin to get me to THINK about going independent. It offers absolutely no safety net of any kind. Please re-consider your strategy and benefits if you truly want to help -- unless, of course, this is simply a marketing ploy to make more money.

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Hey Shari. Kevin here from the Services team. Thanks for the feedback. It's valuable for us to hear. Yes, a $500 one-time stipend varies widely in the difference it'll make for each writer. We've heard from some writers who are paying $500+ per month while others have insurance premiums where $500 will cover to a whole year of premiums. Based on our research, we felt that for the first iteration of this program $500 would be a meaningful amount to start with (for some writers). And that we would quickly learn more about what writers need to make a difference in their lives from feedback like yours. Thanks for writing on Substack and for sharing your thoughts.

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Hey Kevin, thanks for replying so quickly. Glad to know that the feedback was received, and hoping to see the program greatly expanded soon. Understand that this is essentially the first "pilot" phase rollout, so the target audience might be different than me and others like me.

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For perspective, a solo person would have to earn over $70,000/year to pay $500 per month for a benchmark silver plan in the current ACA marketplace (which is where HealthSherpa is selling). In the emergency Special Enrollment Period that ran Feb. 15 - Aug. 15 this year, the average premium paid was $81/month, and nearly half paid $10/month or less. The American Rescue Plan gave subsidies a major boost.

https://www.hhs.gov/sites/default/files/2021-sep-final-enrollment-report.pdf

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This is such an amazing idea! Thank you to everyone who works at Substack and made this possible. I won’t be using it personally (or at least yet haha) but I’m sure there’s many Substack writers who will benefit from this awesome program! Thank you again 😊

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This is fantastic news!

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Has anyone actually put in the numbers to get a quote? These health insurance prices are INSANE and it appears that the stipend is only for one month? I appreciate the sentiment, but this is higher than my student loans.

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Hey Amee, Kevin from the Services team here. Are you open to sharing what state you're checking out health plans in? We know that health insurance premiums vary widely depending on location, and this would be a good data point for our team. No pressure to share though. Thanks for writing on Substack.

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This doesn't apply to me just yet, but wanted to say this makes me love Substack even more. Thanks for taking care of people! <3

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Thank you, Jess. And thanks for publishing on Substack. We're excited to learn from this iteration of Substack Health and continue to build up our support services so that they're eventually available to anyone who needs it.

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As a health and wellness coach, this is just amazing to see. Such a great initiative. I'm up in Canada so this doesn't apply to me, but really excited to see some of the progressive steps being taken like the one you are providing here for U.S. writers. Hopefully we can see this initiative expand to a wider group of writers as the positive impact becomes more clear! Great work Hamish and the Substack team!

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Appreciate the note, Paul! Thanks for writing on Substack.

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A few points for people skeptical about the health insurance they may find in the ACA marketplace -- which is what is on offer here via HealthSherpa:

1. HealthSherpa is very easy to use and shows all plans available in the ACA exchanges at no additional cost to the enrollee. Try the app: you should have a good idea what's on offer and what it will cost you within 30 seconds.

2. The American Rescue Plan, enacted in March, gave ACA premium subsidies a *major* boost, and coverage in 2022 is much cheaper than many people realize. There is no longer any income cap on subsidy eligibility: if you are legally present in the U.S., don't have an affordable offer of insurance from an employer, and aren't eligible for Medicaid or other public coverage, a benchmark silver plan will cost no more than 8.5% of income, and for most people, far less.

3. Benchmark silver coverage (the second cheapest silver plan in an area) is now *free* to enrollees with incomes up to 150% of the Federal Poverty Level -- $19,320 for an individual, $26,130 for a couple, $39,750 for a family of four. For anyone with an income below 200% FPL ($25,760 for an individual, $53,000 for a family of 4), the Substack $500 stipend will cover the entire premium.

4. In comments above, Dan Munro emphasized the super-high deductibles in bronze plans (the cheapest metal level available). That's true; they're awful. And silver plan deductibles are frankly also very high in most areas for people with income above 200% FPL (see above; below that income threshold, strong Cost Sharing Reduction subsidies bring deductibles way down). But most silver plans also offer considerable services (doctor visits, generic drugs) that are not subject to the deductible.

5. In all but 12 states, if your family income is below 138% FPL ($1,482/month for an individual), you will qualify for Medicaid. HealthSherpa will show you that, too, and refer your application to your state Medicaid agency.

6. If you are uninsured, check out your options. HealthSherpa, offered in this program, is a good, quick, reliable way to do it ( I blog about the ACA and use HealthSherpa all the time to check prices in different markets, but I have no relationship with the firm). Good luck!

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... and a few more points.

1. HealthSherpa is hardly unique - and there are organizations tailored to helping freelancers specifically with health insurance - like this one: https://www.freelancersunion.org/insurance/health/

2. Unless/until Substack offers a specific solution - they have no real value add to health insurance that Substack writers select through online brokers recommended by Substack.

3. I can't tell (and I don't really care), but there are often kickbacks for "applicants" or "enrollees" for health insurance bought through many brokers (online or otherwise).

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I just tested the freelancers' app: it's far inferior to the HealthSherpa interface. It's true that other than the $500 grant (not nothing by any means given median ACA premiums net of subsidy), substack's only service here is to point people to HealthSherpa, but that is in itself valuable, given the widespread ignorance of ACA offerings (especially as enhanced by the American Rescue Plan) and HS's ease of use.

HealthSherpa is in fact the dominant direct enrollment platform, accounting for more than 60% of all direct enrollment by commercial platforms. More about them here. https://xpostfactoid.blogspot.com/2021/06/the-second-biggest-health-insurance.html

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I love this, thank you for looking out and caring for the creators on Substack

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