As millions of Americans wait to see how the federal health exchanges shake out, some who’ve been hanging onto their jobs just for the insurance say Obamacare gives them a new reason to bid their old employers goodbye.
One Arizona couple, Claudia and Joseph Schulz, just quit their jobs, in fact, and launched a husband-and-wife real estate team, largely because they can sign up this week for health insurance not tethered to any position.
“That was the fear before. We felt too much on our own,” says Claudia Schulz, 33, of Phoenix. “Now, if we’re able to make our dream come true of owning our own business, or at least giving it a shot, it’s worth it.”
Starting a business or retiring early will suddenly become an option under the new exchanges, experts say, especially for the many employees who have felt trapped by so-called “job lock” -- being stuck in a position because of the benefits, usually health insurance, it provides.
“The Affordable Care Act completely changes the playing field,” says Paul Fronstin, director of the health research programs at the Employee Benefit Research Institute. “You don’t need your employer any more for health benefits.”
It may be particularly attractive for older workers -- those in their late 50s and early 60s still too young for Medicare -- who will find they can get affordable insurance despite health problems. That will free them from the trap of needing to work, but being too sick to stay on the job, experts say.
Entrepreneurs of all ages will be able to choose careers “based on the job where they’re going to be most productive,” says Laurel Lucia, a policy analyst at the Center for Labor Research and Education at the University of California, Berkeley.
But experts also caution there are many unknowns lurking in the launch of the exchanges. They’re a cornerstone of the ACA, widely known as Obamacare -- the 2010 law aimed at boosting access to coverage so that more Americans will take care of their health.
Despite years of discussion, many Americans aren’t aware that the ACA may apply to them, including the 27 million it aims to cover by 2017. In late August, a month before the launch, four in 10 Americans were still unsure about whether the ACA remained law, according to a Kaiser Family Foundation poll.
“There’s very little knowledge out there at this point,” says Dean Baker, co-director of the Center for Economic and Policy Research, a liberal-leaning think tank in Washington, D.C. “We don’t know exactly what these plans will look like.”
Costs, provider choices and which benefits will be available on the range of basic “bronze” to cover-everything “platinum” plans have been estimated and modeled, but they won’t be certain until the exchanges go live as expected on Tuesday. Even then there will be changes and glitches, experts say. The federal government will run or help run the plan in 36 states; the rest plan to run their own.
About 7 million people are expected to sign up on the insurance exchanges, according to the Congressional Budget Office. That could include up to 1.5 million newly self-employed people as a result of ACA, according to a joint study by the Urban Institute’s Health Policy Center and Georgetown University.
“The idea is that when people have employer-sponsored insurance, even if they would like to start their own business, they might be reluctant to leave that job that provides them insurance coverage if they’re not confident they would be able to access affordable health coverage some other way,” Carole Gresenz, a health economist at Georgetown, told NBC News.
That was certainly the case for Claudia and Joseph Schulz, the Phoenix couple who campaigned for health care reform in red-state Arizona, never knowing they’d need it themselves.
“We both worked for national builders. We both made a six-figure income,” Claudia Schulz says.
Then, in 2008, when the recession hit the construction industry hard, they both lost their jobs. At the same time, Claudia discovered a lump in her breast and Joseph developed a swollen lymph node in his groin, a possible sign of testicular cancer.
“I was going to lose my health insurance a week before my surgery,” she says. “I remember thinking, if it does turn out I have cancer, how am I going to keep my insurance? I remember thinking, oh my god, health insurance is a trap.”
Neither turned out to be sick, but the effects of the scare lingered. Joseph Schulz, a mortgage broker, took a job at an online university temporarily just to have insurance to cover the family, which includes three children ages 10, 7 and 2. Claudia went back to school for a master’s degree.
They were both hired back into corporate real estate jobs, but the Schulzes always wanted to work on their own. That’s when they remembered Obamacare.
“We thought, that law is actually going to be real now,” Claudia Schulz says. “Hey, we could get that insurance. We never thought of that for us.”
In September, Joseph Schulz quit his job as a mortgage broker and Claudia Schulz arranged to work as a consultant for her former firm. They have employer-sponsored insurance through Monday.
On Tuesday, they plan to sign up for the new exchanges in Arizona, where five insurers have filed to offer care. Based on their projected $150,000 income, plus family size, the Schulzes may pay about $1,250 a month in premiums for a silver plan, or more for the top-tier platinum plan they favor, according to a calculator offered by the Berkeley labor center. At 544 percent of the federal poverty level, that’s well out of range for any government subsidies.
The care will start Jan. 1. Until then, the Schulzes figure they’ll pay about $1,600 a month for COBRA benefits to extend their insurance. That’s all a big bite out of the family’s budget, far more than the $420 a month they’ve been paying.
The extra cash -- and talk in Congress of defunding Obamacare -- raises some questions about their decision, they admit.
“To be honest, we have that fear, that they might cancel it and it may not happen. We’d have to go back to employer-based insurance,” Claudia Schulz says. “But we’re still going through with it.”
In fact, a family emergency this week reinforced their support for affordable, independent insurance. Joseph Schulz’s 57-year-old stepfather suffered a sudden stroke on Tuesday that may leave him permanently disabled. The lifelong construction worker was recently laid off from his job and has no insurance. He may qualify for Social Security disability, but he’ll also be able to get health care through the new exchange.
Still, others considering quitting their jobs for Obamacare remain cautious. Jay Narey, a 49-year-old flight attendant in Dallas, says he plans to leave the skies and start a commercial real estate business -- but not until late next year, after any glitches are addressed.
“I’m definitely interested,” says Narey. “Having access to health insurance is absolutely critical to self-employed individuals like me who no longer wish to be chained to a specific employer.”
And one 35-year-old Austin, Texas, man tells NBC News he plans use Obamacare to leave his “not exactly fulfilling” corporate job to become an independent consultant for a favorite food product. But he doesn’t want to share his name because he hasn’t told his boss – and he still needs insurance to cover his wife’s rheumatoid arthritis, a pre-existing health condition.
“I don’t know that we want to be the ones to lead out on the experiment,” the man says. “We’re probably going to wait and see how it all shakes out.”
JoNel Aleccia is a senior health reporter with NBC News. Reach her on Twitter at @JoNel_Aleccia or send her an email.