Here is another way to look at the side effects of Health Care Reform:
JoNel Aleccia, NBC News
As millions of Americans wait to see how the federal health exchanges shake out, some who’ve been hanging onto their jobs just for the insurance say Obamacare gives them a new reason to bid their old employers goodbye.
One Arizona couple, Claudia and Joseph Schulz, just quit their jobs, in fact, and launched a husband-and-wife real estate team, largely because they can sign up this week for health insurance not tethered to any position.
“That was the fear before. We felt too much on our own,” says Claudia Schulz, 33, of Phoenix. “Now, if we’re able to make our dream come true of owning our own business, or at least giving it a shot, it’s worth it.”
Starting a business or retiring early will suddenly become an option under the new exchanges, experts say, especially for the many employees who have felt trapped by so-called “job lock” — being stuck in a position because of the benefits, usually health insurance, it provides.
“The Affordable Care Act completely changes the playing field,” says Paul Fronstin, director of the health research programs at the Employee Benefit Research Institute. “You don’t need your employer any more for health benefits.”
It may be particularly attractive for older workers — those in their late 50s and early 60s still too young for Medicare — who will find they can get affordable insurance despite health problems. That will free them from the trap of needing to work, but being too sick to stay on the job, experts say.
Entrepreneurs of all ages will be able to choose careers “based on the job where they’re going to be most productive,” says Laurel Lucia, a policy analyst at the Center for Labor Research and Education at the University of California, Berkeley.
But experts also caution there are many unknowns lurking in the launch of the exchanges. They’re a cornerstone of the ACA, widely known as Obamacare — the 2010 law aimed at boosting access to coverage so that more Americans will take care of their health.
Despite years of discussion, many Americans aren’t aware that the ACA may apply to them, including the 27 million it aims to cover by 2017. In late August, a month before the launch, four in 10 Americans were still unsure about whether the ACA remained law, according to a Kaiser Family Foundation poll.
“There’s very little knowledge out there at this point,” says Dean Baker, co-director of the Center for Economic and Policy Research, a liberal-leaning think tank in Washington, D.C. “We don’t know exactly what these plans will look like.”
Costs, provider choices and which benefits will be available on the range of basic “bronze” to cover-everything “platinum” plans have been estimated and modeled, but they won’t be certain until the exchanges go live as expected on Tuesday. Even then there will be changes and glitches, experts say. The federal government will run or help run the plan in 36 states; the rest plan to run their own.
About 7 million people are expected to sign up on the insurance exchanges, according to the Congressional Budget Office. That could include up to 1.5 million newly self-employed people as a result of ACA, according to a joint study by the Urban Institute’s Health Policy Center and Georgetown University.
“The idea is that when people have employer-sponsored insurance, even if they would like to start their own business, they might be reluctant to leave that job that provides them insurance coverage if they’re not confident they would be able to access affordable health coverage some other way,” Carole Gresenz, a health economist at Georgetown, told NBC News.