Chicago Tribune Rex Huppke column

Jan. 19--The Affordable Care Act and working people are linked in ways that are often overlooked. But with the health care law likely to be repealed by a Republican-controlled Congress under President Donald "Obamacare is a Disaster" Trump, it's worth looking at -- and caring about -- the worry and confusion many workers now endure.

Whatever your opinion on the ACA, it gave many entrepreneurial people the ability to strike out on their own and leave full-time jobs with companies that provided health benefits.

Private insurance was always available for freelance workers or small-business owners, but the premiums could be prohibitive, particularly for people with pre-existing conditions, and the coverage was often subpar.

The ACA, even with its many flaws, opened the door for people to work on their own terms -- to start businesses or to stitch together careers as freelance or gig workers.

Now, with no clear sense of what would replace the ACA if it is repealed, workers across the country who rely on Obamacare are in limbo and, in many cases, thinking a return to full-time company work might be required.

The ACA allowed Andy Freivogel to leave a full-time job with Intelligentsia Coffee & Tea in Chicago, one that provided him and his family with health care, and start his own internet technology company in 2014.

His wife, Laurie, is an artist with an established business of her own.

Andy and Laurie and one of their two children have asthma, but they were still able to get coverage for about $700 per month.

"It would've been impossible to buy that before, with pre-existing conditions" he said. "We wanted to build something for ourselves that is possibly an enterprise we can hand off to the kids or something we can build up and sell off to someone, kind of a last Hail Mary of our careers."

Obamacare hasn't worked flawlessly for the Freivogels. They had to switch to a different insurance company and the family's monthly premium has gone up to almost $1,200 per month.

But both say it's still far better than anything they could have gotten pre-ACA. And they're worried the whole system could soon be on the way out.

"I've been angry at elections, but I've never been scared," Laurie said. "I'm scared for my children."

Andy is having to consider the future of the company he launched, which provides IT services to independent retailers.

"I'm already thinking, 'What are my options for getting a full-time job that will allow me to get benefits?'" he said. "If one of us has to do it, it'll be me. And if they say repeal is going to take effect in 2017 or 2018, then I have to start looking for that job now, because those jobs are going to be hard to find."

Last week, I tweeted out a request to speak with people who do freelance work or run their own businesses and rely on Obamacare. Responses came in from across the country, by the dozens. And most of them mirrored the worry currently felt in the Freivogel family's suburban Chicago home.

Wendy Grahn and her daughter recently opened a shared commercial kitchen in Chicago. More than 30 independent food companies use that space.

Grahn, who is diabetic, worked in a corporate setting for three decades, staying longer than she wanted because of health insurance coverage.

"When the ACA came about, it was a driving factor in making a career change and opening a business," she said. "I don't think the ACA is perfect, not at all. But it's a start. So my preference would be to fix the parts that aren't working rather than scrapping the whole thing."

But she can see the writing on the wall, at least at this moment: Republicans seem determined to do away with the ACA, and they've been unable to provide a detailed plan for its replacement.

"The only option that's out there, they want to take that way from me," Grahn said. "It makes me look ahead thinking I have to change everything and go back and get a corporate job to get insurance. I makes me worried that I might need to close down the new business and not give it a chance to get going."

I understand that people have been hurt by Obamacare, because of everything from premium and deductible increases to having to switch doctors. But people also have been helped, and the path we're on right now puts everyone -- those hurt and those helped -- in a cloud of uncertainty and half-baked political promises.

Emily Lallouz is a 34-year-old freelance casting producer in Los Angeles. She's pregnant, due in April, and worried.

"It's hard to prepare and plan for something that is so uncertain," she said. "Nobody knows what's going on. I'm due in April. What could even happen between now and then? Will I be able to go to these important doctor's appointments that I need to?"

Meg Craig is a 30-year-old kidney donor covered by the ACA through the nonprofit organization where she works in Chicago. (Craig also does freelance editing, sometimes for the Chicago Tribune.)

"If the pre-existing condition clause goes away, I'm essentially uninsurable," she said. "I don't have plans to leave, but if I had to think about being able to pay for the cost of health care and it wasn't feasible at this place or any other, I can't just be uninsured. I don't want to be forced into a situation like that. I love what I do, I want to keep doing it and I don't want insurance to be the thing that forces me out."

That's a key point in all this: The need for affordable health insurance shouldn't be the reason people have to stay in jobs they don't want. That stifles creativity, increases stress and decreases productivity.

It's a lose-lose scenario, not to mention a morally questionable one.

I know Obamacare needs fixing. And perhaps it does need to be scrapped and replaced with something else.

But working people like the Freivogels and Grahn and others deserve clarity -- quickly. Republicans have been criticizing and getting in the way of the ACA since its inception. They've had eight years to come up with a sensible replacement that will perform even better.

It's time to show American workers a replacement plan. And if Republicans can't do that, it's time to get to work at making the ACA better.

TALK TO REX: Ask workplace questions -- anonymously or by name -- and share stories with Rex Huppke at rhuppke@chicagotribune.com, like Rex on Facebook at www.facebook.com/rexworkshere and find more at www.chicagotribune.com/ijustworkhere.

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