The Elephant in the Room: Health Insurance

Many people want to be able to embark on a self-employed sustainable livelihood. However, many feel afraid to quit their rat-race jobs because they don’t want to lose their health insurance. The following post is my attenpt to address that elephant in the room, and hopefully to help some of you feel more able to “make the leap” to your self-employed right livelihood of choice. Be it teaching, childcare, eco-friendly laundry service, regenerative landscaping, farming, art, making yogurt, starting a neighborhood composting business, sewing, carpentry, bicycle repair, community event planning, singing/songwriting, publicity, journalism, or whatever your passion that meets a real need in the world. (Note: This is a USA-centered post but may be relevant to folks in other countries also.)

What’s missing from a lot of the discussions on this topic is that self-employed people can in fact get health insurance coverage under the Affordable Care Act. My understanding is a person just needs to have Adjustable Gross Income of 13k or more to qualify (Actually I just read the minumum for 2021 is $12,760). For many self-employed people, this is very do-able. And at that minimum AGI, my understanding is that the premium is very low, maybe $10 or $20 per month (but this can vary by state).

I’m self-employed and don’t have health insurance – do not meet the income requirement to qualify. (My adjusted gross income is too low.)

As a person with anarchist leanings politically, for a long time I was hesitant to even think about getting subsidized insurance (or recommending it to others). Like, if my state (Florida) had expanded Medicaid, I would have felt guilty about being on it, because I’m a privileged person who chose to drop out of the middle class, and burned most of my bridges to middle-class income.

But over time, my thinking has shifted.

1) The crisis in our healthcare system has mainly been caused by government and insurance companies, so for now at least, government and insurance companies will need to be part of the solution.

2) It is in the interest of the collective public health for each individual to have access to affordable healthcare, not be at risk for losing the roof over their head any time they get sick.

And moreover, 3) My work as a self-employed sustainability educator is a worthwhile contribution to society, despite the fact that I have not yet consistently reached my target annual income of 13k.

So I am now tentatively recommending that folks who are trying to muster the courage to quit their jobs and pursue their dream sustainable/permaculture self-employed right livelihood, do so, bearing in mind that all you need is less than 13k AGI to qualify for insurance. With the 12k standard IRS deduction that should mean you only need to gross 25k a year to be able to get your health insurance premium fully covered. (My AGI for the past few years has generally hovered around 5k to 10k, but i am aiming for 13k.) I am not 100% certain about this but it is to the the best of my current knowledge and research.

One friend who is thinking along similar lines says her understanding is that a person’s gross income doesn’t have to reach $25,000 to meet the approximately $13,000 AGI threshold necessary for ACA Marketplace insurance. Her understanding is that a person obtaining health insurance through the marketplace simply needs a gross (not net) income of $13,000. I will update you with any more definitive info I find.

Another key point: People with kids may have higher premiums. I had been assuming that children would come under some sort of state or federal coverage — they do even in my home state of Florida, which is not known for such socially minded things. I will comment more on this essential aspect of coverage for kids as I find out more.

So there you have it. Encouragement to pursue self-employed right livelihood that will fulfill you while also enriching your community and helping to build a greener, saner world! If you want more encouragement, I strongly suggest you join the Transformative Adventures group on Facebook. Hope to see you over there! It’s a nurturing pod and an inspiring incubator!

Oh, and a final note from me: Never forget that health insurance is not synonymous with actual health care. Though the latter term often gets used when what’s meant is “insurance,” it’s good to remember they are two different things.

Further Exploration:

FI Healthcare (“Healthcare Options, Explained — For Those Pursuing Financial Freedom”): “It’s time for the FI/RE movement to come together to help each other figure out health care options in early (or semi) retirement. No, it’s not the most glamorous topic, but this site was developed for those who believe it is time to come together with a united purpose of making health care options better understood – now, that’s what we call exciting.”

2021 Obamacare Subsidy Chart & Calculator (healthcareinsider.com): Subsidy calculator tool lets you input your ZIP code etc.

Harnessing Healthcare (Facebook group for health-insurance-related info).