Progress Update, March 2005
By: Claudia Bach, AdvisArts Consulting

About WAHIP

The Washington Artists Health Insurance Project (WAHIP) is an effort to develop new strategies to improve access to health insurance for artists. WAHIP is working to expand access to health insurance for artists working in all disciplines, from painters and poets to rock musicians and choreographers, and all individuals who are dedicated to a profession in the arts. The work of WAHIP will provide leadership in developing models relevant to artists in other regions and for other populations with similar characteristics.

WAHIP is a partnership project between Leveraging Investments in Creativity (LINC) and Artist Trust and is supported by the Allen Foundation for the Arts, Ford Foundation, and Nathan Cummings Foundation. LINC (www.lincnet.net) is a ten-year national campaign to improve conditions for artists in all disciplines, so that artists can more readily do their creative work and contribute to community life. The National Artists Insurance Initiative, LINC’s national companion project to WAHIP, has identified innovative programs around the country and has developed other tools and connections towards enhancing access to health and other types of insurance. Artist Trust has been providing information and direct grant support to Washington State artists for over 17 years. Artist Trust serves as a national model for support of individual artists. Over 40 arts and cultural organization in Washington State and numerous health policy and insurance experts are working with WAHIP, and many more support its efforts.

Key findings to date about artists and health insurance
Health insurance is a critical issue for artists, as it is for countless Americans. The likelihood of being uninsured is greatest for those with lower incomes, young adults ages 19 to 34, adults without dependent children, individuals in fair or poor health and those who are self-employed. Artists with these characteristics are among the over 45 million Americans who lack health insurance. There is one significant factor emerging regarding artists: The Washington artist population is more than four times as likely to be self employed as the general population. This translates into less access to employer-sponsored insurance plans and the reliance on higher cost individual insurance plans. The result is a higher proportion of artists’ income is likely to be required for health insurance and artists face higher hurdles in locating or qualifying for affordable health insurance plans.

Trends shaping the health insurance landscape
Health care and health insurance costs continue to rise unabated. As employers battle increasing health insurance costs they are passing on more of these costs to the individual employee through higher premium sharing, higher deductibles, co-pays and other cost sharing mechanisms. Many small businesses are providing no health insurance at all to their employees. Large corporations and small businesses alike see health care costs as having a significant impact on their competitiveness in the marketplace. State and federal regulations tackle these issues with a variety of programs and laws. Each state enacts unique legislation that often creates complex and changing variations and options for businesses and consumers. Continuing shortfalls in state budgets make government-only solutions unlikely. There is an increasing expectation that consumers will make health care purchasing decisions to maximize value and reduce spending. Such trends highlight the increasing role of the individual regarding responsibility for their own (and their family’s) health insurance and health care needs. This represents a shift from the existing health insurance model in the US in which the employer or government is the conduit to health insurance.

How artists fit into these trends
Due to their occupational patterns, artists are frequently outside of the employer-based insurance system. Many artists work independently, either through self-employment, freelance work, short term cycles of employment or multiple employer relationships. Workers in other diverse occupational groups are ending up in a similar situation, whether by choice or circumstance. Artists’ age-old employment patterns appear to now be more prevalent in the larger work force.

Roles artists might play in the future of health insurance
The artist population may prove an important occupational group for exploring new and innovative models. New models for health insurance are emerging beyond the existing employer-based approach. Insurance that is “direct-to-individuals” –where there is no intermediary such as an employer or group--is a promising arena for investigation. Insurance products designed for occupational groups may also offer new possibilities. As a population that is not well served by traditional employer-based models, artists provide a definable yet economically diverse group. Additionally, artists generally bring a high level of education and openness to new ideas that may be important in breaking new ground in health insurance.

Who needs to be part of this process
The WAHIP process has brought diverse sectors to the table to work on the challenges of health insurance. It is evident that no one industry or sector can make progress without the expertise and goodwill of a combined approach. It will take the knowledge and creative thinking of individuals from health policy, health care, the insurance industry and government, as well as artists and arts organizations, to craft new ideas that can lead to increased access. Change requires that ideas and opportunities from across the political spectrum be respectfully considered and perhaps crafted in new ways. New approaches are likely to require innovative responses from all players whether artists, insurers, legislators or health care providers.

WAHIP in 2004-2005
WAHIP has undertaken a two-year process to explore options to expand access to health insurance for artists in Washington State. It is hoped that what is learned through this process will lead to tangible change over the next few years. It is expected that the tools developed and the lessons learned will be utilized in other states, and that they will prove useful in serving other populations or occupational sectors that share similar employment characteristics with artists.

During this two year period WAHIP’s work includes:

• A WAHIP Advisory Group of experts from health policy, workers’ benefits, insurance and the arts has been created and is currently guiding WAHIP as a cross sector effort.
  
  
• A report, Artists and Health Insurance: Existing Data and Implications for the Washington Artists Health Insurance Project, has been completed. This report analyzes and synthesizes all available Washington State data on the state’s artist population and health care status, and relates it to national data and research from diverse sources including the US Census and arts organizations’ surveys. It also identifies additional information needed through survey research.
  
  
• A WAHIP Survey of the Washington State artist population and their health care and insurance access and needs is being launched in March 2005. This survey has been developed by WAHIP working with theSocial and Economic Sciences Research Center (SESRC) at Washington State University , with input from insurance and health policy experts and artists. The survey instrument and methodology are suitable for replication in other states. The results of the survey are expected by July 2005.
  
  
• A WAHIP Forum is scheduled for summer 2005 to bring together Washington State and national experts and innovators related to health care, health insurance and services for artists. This forum will share information gathered through WAHIP research and use it as the basis for working sessions to develop models. It is expected that new models, or renewed examination of existing models, will provide the basis for implementation of a pilot project.
  
  
• Based on the WAHIP research and forum, a preliminary plan for a program or service that will increase health insurance access for artists in Washington State will be drafted by the end of 2005. This plan will identify possible partners and financing mechanisms and define next steps.

Please see WAHIP Progress Update for an overview of trends shaping health insurance and how artists fit into and may provide new opportunities to respond to these trends due to their work patterns that often place them outside traditional employer-based health coverage.