Clinic’s Safety Net Catches Health Care Reform Questions

Hirschfeld Free Health Clinic

As politicians bicker about the clouds that linger over ongoing health care reform, one beacon of light continues to shine brightly on New York City’s West 57th Street.

The Actors Fund’s Al Hirschfeld Free Health Clinic, supported again last year with a $600,000 grant from Broadway Cares/Equity Fights AIDS, remains on the front lines, addressing the immediate needs of those in the entertainment industry who are uninsured or underinsured.

“Even for people who have their insurance through the Affordable Care Act or who may be dealing with a high deductible, the clinic is there for them,” said Barbara Davis, chief operating officer of The Actors Fund. “It’s about preventing illness as much as possible and addressing it as quickly as possible. That’s why we think the clinic is still really important to people right now. If you need to be seen by a physician, don’t be shy or hold back, come see the doctor.”

The clinic opened its doors in 2004 with a $500,000 grant from Broadway Cares. Since then, BC/EFA has provided more than $6.76 million in support of the clinic and remains its largest funder.

“We’re always proud to stand with our friends in the theatre community by championing The Actors Fund’s myriad lifesaving and life-affirming programs and services not the least of which is the Al Hirschfeld Free Health Clinic,” said BC/EFA Executive Director Tom Viola.

patient on wheelchairIn addition to the Hirschfeld Clinic, The Actors Fund provides a safety net of social service programs that includes the HIV/AIDS Initiative and the Phyllis Newman Women’s Health Initiative. Thanks to the generosity of Broadway Cares/Equity Fights AIDS supporters, BC/EFA awarded $4.3 million last year to The Actors Fund. Broadway Cares remains the single largest funder of The Actors Fund programs.

A recent Actors Fund survey found that more than 43 percent of individuals working in the visual and performing arts lack health insurance coverage – more than double the national uninsured rate. That underscores the need for the Hirschfeld Clinic and, for the entertainment community, brings a heightened sense of urgency to the roll-out of the Affordable Care Act.

“In addition to the day-to-day support of thousands in the industry, The Actors Fund has ensured that the daunting process of understanding the Affordable Care Act and enrolling in coverage can be manageable, supported and relatively stress-free,” Viola said. “They have also stepped up in a leadership capacity among health and social service organizations, setting the bar high on how to meet the needs of a diverse constituency in a complicated and polarizing political climate.”

For some, implementation of the Affordable Care Act means learning a new, sometimes confusing, language that includes talk of health care exchanges, subsidies and out-of-pocket maximums Fortunately, in addition to the care provided by the Hirschfeld Clinic, The Actors Fund has a built-in translation service that’s been working full-steam for years to connect artists, craftspeople and entertainment industry workers to health insurance.

The fund’s Artists Health Insurance Resource Center, also known as AHIRC, was started in 1998 with the singular mission to insure every artist in the United States. Now that that goal is closer to reality, AHIRC is positioned to help the industry understand the Affordable Care Act, its opportunities and its implications.

“For the people we serve, it’s still about making sure they’re getting the care they need,” Davis said. “Look at what happens when you’re working with a theatre company and one of the members gets sick. It can spread quickly through the whole company. This is still about preventing illness as much as possible and, when it does happen, addressing it as quickly as possible.”

AHIRC Client Mizuo Peck with Risa Neuwirth photo by Karissa KrenzThis spring, Broadway Cares made a special $250,000 grant to The Actors Fund to support AHIRC and the efforts to connect members of the industry to the new insurance exchanges and plans.

At its core, the Affordable Care Act increases access to health insurance for every American, requires free preventative care and prohibits insurance companies from denying coverage because of pre-existing conditions.

With in-person counseling in New York and Los Angeles, national telephone support and workshops throughout the country, AHIRC continues to work to reduce the number of uninsured artists and expand access to quality, affordable health care.

Renata Marinaro, director of health services for the eastern region, is one of those tireless Actors Fund staffers helping to educate the industry. She even attended the mega South by Southwest festival in March, offering health insurance counseling to attendees with a special effort to reach out to uninsured musicians.

Among the more well-received developments of the Affordable Care Act is the requirement that all new plans cover certain preventative services for free – services that those in the performing arts often bypassed. These include certain breast, colon and cervical cancer screenings; blood pressure, diabetes and cholesterol tests; vaccines, immunizations and flue shots; and HIV and STD testing.

And while the benefits are expansive, there has been some sticker shock at the initial costs. Coverage can set an actor or dancer back $200 or more per month with deductibles as high as $3,000. But any single person who earns less than $46,000 is eligible for subsidies to help reduce the monthly cost.

“Recently we worked with a woman who had been on the same plan for a really long time and was paying $800 a month,” Marinaro said. “Her income was $30,000 a year, so that was a huge chunk of change for insurance. We found able to find her a really, really nice plan for $300 a month with the subsidy, saving her $500 a month.”

Even once someone gets insurance – whether it’s through an exchange or their employer, there’s still a lot to understand, which is where The Actors Fund again helps out.

“We’re getting a lot of people who simply don’t know how to use their insurance,” said James Brown, AHIRC’s director of health services, national. “We’re in the process of creating a comprehensive seminar on fully understanding your insurance benefits – how to file a claim, make an appeal, all the processes that are in place to truly use your health insurance to its full advantage.”

In the meantime, the Hirschfeld Clinic stands ready to serve the uninsured and underinsured. “They’re providing that primary care that’s so important,” Brown said. “Without it, that’s often how things lead to worse problems. It’s not just prevention, it’s early diagnosis. The clinic really is the doctor’s office for the industry.”