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Michael Knipp, 24, needed to get one of his wisdom teeth removed. It had abscessed while he was avoiding an expensive trip to the dentist’s office. Nicole Saunders, 29, was in good health and rarely got sick, but she constantly worried that if anything endangered her health, she might lose her home. Melanie (she requested we not use her full name), 36, who underwent major surgery, had to get a costly MRI scan so doctors could look more closely at her body tissue. Michael Harris, 30, cut his hand while chopping green peppers. Scott Sherman, 39, searched for a doctor to administer vaccination shots before he could travel to India.

Though these people have never met, they all have one thing in common: They are all freelance writers with healthcare problems or concerns. Where they differ is in their ability to cover the costs of medical care.

When Michael Knipp needed dental work, he had no health insurance. So he went to the University of Maryland’s Dental School and had aspiring professionals remove the aching tooth for a low fee. Nicole Saunders, who had quit her staff-writing job at Consumer Reports, considered signing up for medical coverage through COBRA (the Consolidated Omnibus Budget Reconciliation Act), which extends group health coverage to workers who are terminated or who resign “for reasons other than misconduct,” but thought it was too expensive for a single woman without children. Instead, she took a job as the managing editor of Uptown magazine to get full benefits.

Melanie was not so lucky. A divorcee formerly covered by her spouse’s insurance, she had to find an individual health plan. Melanie chose one that cost her $175-plus per month, but to keep the monthly payments at that level, she had to accept a high deductible. When Michael Harris was laid off from a staff-writing position at The Source, he opted for COBRA, which currently costs him $400 per month.

Scott Sherman, a contributing writer for The Nation, faced the same kind of decision. He decided to try something new. He canceled his health insurance—a policy covering catastrophic illnesses or accidents—and joined the Freelancers Union, a nonprofit organization that provides group benefits to independent workers for nearly half of what Harris pays. It does what politicians this election year only offer as puffy rhetoric; it provides health insurance that everyone can afford.

Anyone who has followed the debates between Hillary Clinton and Barack Obama knows that both have been slinging around the phrase “healthcare for every American” as if it were the stone that could slay the Goliath gridlock among Democrats. We learned from the debates that 47 million Americans were not insured in 2006. What we didn’t hear was that almost one-third of the 306,000 writers and editors in this country were self-employed at that time, according to U.S. Bureau of Labor statistics. Many of them cannot afford health insurance.

Book writers have The Authors Guild. Those who join can avail themselves of the health insurance that has been offered to members for more than 15 years, with HMOs starting at $342.99 per month for singles. “Providing health insurance is very important to our members, since they can apply under a group plan, as opposed to applying individually,” said Michael Gross, the Guild’s health insurance coordinator. “Not only does it save the members paperwork, but ideally, the group plan should function to save members money.”

The Freelancers Union was established to do this—and more. Founded in 1995 as Working Today, a group intended to address the needs of independent workers, it changed its name in 2003 to the Freelancers Union and redefined itself as a nonprofit organization that is free to join, offers benefits and represents its members through “advocacy, information and service.” That’s to say, it exists not only to procure a lower rate of insurance for independent workers—including freelance writers, temporary workers, consultants, independent contractors and the self-employed—but to promote relevant policy changes.

“What I’m realizing right now, in 2008, is the issue of being a freelancer is part of a larger social movement,” said Sarah Horowitz, founder of the Freelancers Union, whose vision was shaped by her background as a labor lawyer. “It’s common sense that we can do better in a group than as an individual,” she said. Individual insurance rates in the Union start around $130—40 percent cheaper than for nonmembers.

The Employee Benefit Research Institute has reported that individual insurance policies can be problematic. Though low-premium policies exist, such policies have limitations on benefits like prescription drugs and require high deductibles—the amount of money the policyholder must pay before insurance kicks in.

Melanie knows all about that. A large insurer denied her application because of concerns about her MRI scan, which the company considered a “pre-existing condition.” The only way she felt she could get insurance was to avoid revealing her medical history. That required Melanie to get a plan with a higher deductible. Still, last year, when she unexpectedly had to have major surgery, she truly appreciated her coverage, as expensive as it was. “The cost of everything was about $33,000 and I still paid a lot out of pocket. It was $3,500 between the deductibles and co-pays,” she said. “But $3,500 beats $35,000.”

Freelancers are not the only ones to suffer. The hefty price tag on insurance—an average, in 2005, of $4,000 annually per individual and $11,000 per family—has caused companies to cut back on coverage for employees. This trend has left independent magazines like Bitch in a moral quandary. Andi Zeisler, Bitch’s editorial director, said that she noticed an increase in staff turnover when the magazine was based in Oakland, Calif. The recent college grads she hired “weren’t really super concerned about things like health insurance.” But when they reached their late 20s, they got “tired of going to free clinics” and quit because they wanted better coverage. According to Zeisler, the question for the magazine became, “How can we pay an affordable living wage and health insurance, even for part-time people, and be somewhat successful in our own small way?” The magazine decided to relocate to Portland, Ore., where insurance rates were lower. All employees, “even the part-time folks,” have health insurance now.

As for the 39 percent of freelancers who have experienced gaps in insurance (according to recent surveys), the Freelancers Union may be an attractive option. Its least expensive plan ($130.37 per month) has a high deductible for serious injury or illness (so don’t get too sick). Members with this plan pay out of pocket for discounted rates on all in-network medical expenses up to $10,000 per year. After meeting the $10,000 deductible, all in-network expenses are covered 100 percent for the remainder of the year, except for prescription drugs, which are covered at 70 percent. A married couple that wants a more comprehensive plan can go for the $470.32 per month option that requires a co-payment only for outpatient medical care like doctors’ visits and prescriptions.

There are, of course, rules for participation in the group plans, and it’s difficult not to get bogged down by the long list of eligibility requirements. Most freelancers meet the first few: “You must be an independent worker” and work in specified industries like the arts, design, entertainment, media, nonprofit or technology. You also must live or work in New York state to qualify for some of the plans; outside New York, coverage varies, depending on location. Applicants must prove that they are truly freelancers by offering evidence that they have either worked “at least 20 paid hours in each of the last eight weeks or earned at least $10,000 for work done within the last six months.”

Nicole Saunders, who considered joining the union before landing her job at Uptown, found the enrollment process daunting. “They ask for a lot. They ask for your bank records, they want pay stubs, they want letters from your employer or people that you’re freelancing for,” she said. “So if you aren’t consistently getting work, it’s going to be hard for you to get insurance with the Freelancers Union.”

But Union members across 31 states seem to find these requirements less worrisome than navigating through red tape at insurance companies. “We now have 67,000 members and around 60,000 unique visitors per month to the website,” said Horowitz. She has also partnered with the National Writers Union, which represents the general interests of freelancers, and other organizations to offer members specially discounted insurance rates.

In past years, when the Union used the Health Insurance Plan of New York (HIP) as a provider, the quality of the doctors available became an issue. Scott Sherman said that often those who treated him were young, just out of medical school. “I would have preferred doctors with more experience,” he said, but, all in all, he gives the Union positive marks. “It’s a good organization,” he said. “I’m glad that they’re there. Without it, I would have been in much worse shape.”

The Freelancers Union switched providers in December 2007 to Empire BlueCross BlueShield, which offers “better hospitals and, for the most part, better doctors,” according to Horowitz. Plans are now less expensive for people who have families but costlier for single members. Membership has been increasing by about 3,000 members per month, Horowitz said. “I think it’s because we really focus on providing value.”

Perhaps more importantly, the Freelancers Union is not waiting for politicians to effect change. Just last year, its lobbying efforts helped get a bill passed that increased the tax credits for New York City’s Unincorporated Business Tax, which many local freelancers must pay in addition to personal federal, state and city income taxes. “Seeing such openings in the policy debate” is what Sarah Horowitz finds most rewarding. “Our members are part of that, changing their own economic situation,” she said.

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