Solos, Small Firms Experience Side Effects of Affordable Care Act

, New York Law Journal


Lorese Phillips
Lorese Phillips is a solo practitioner who advises people with disabilities on insurance benefits, is losing her own coverage through the New York City Bar Association.

The rollout of the federal Affordable Care Act has produced some uncomfortable side effects for several hundred lawyers in New York. Virtually all participants in healthcare plans offered by the New York State Bar Association and New York City Bar will see changes to their benefits next year.

The biggest changes affect solo practitioners, most of whom will be dropped from their bar groups' health programs in 2014 under new federal requirements for insurers.

Until now, most solos have qualified for small group coverage under their bar association programs. Health plans for groups typically carry lower premiums and access to wider networks of healthcare providers than policies written for individuals. The Affordable Care Act, however, requires "sole proprietors" to purchase individual health coverage if they do not employ anyone but themselves, meaning many of them no longer qualify for small-group plans.

That's the case for Lorese Phillips, a Manhattan solo whose practice focuses on estate planning and elder law. She has been paying $825 per month, or about $10,000 annually, for healthcare coverage through the city bar's program.

Phillips, 56, said she was "blindsided and angry" when she learned two weeks ago she no longer qualifies for the small-group coverage. She said she'd been "relying on the President's assurances" that she would be able to keep her existing health plan and doctors.

The city bar has brought in an insurance broker to work one-on-one with solos who now must find individual policies. But the only alternative offered by the city bar's insurance provider, Oxford Health Plans, features a limited network that Phillips' doctors aren't part of, she said. She has not yet decided whether she'll sign up.

"I highly respect my team of physicians," Phillips said. "I worked very hard to find people I respect and trust, and I would be disheartened to leave any one of those people because of the loss of my insurance."

The ACA attempts to "grandfather" in existing health plans if they meet certain standards. But those standards have proven too strict for many plans, causing insurers to scrap them altogether. As a result, cancellation notices have gone out to more than four million Americans.

Many people will end up paying more per month on the individual insurance market. But even where monthly premiums are less expensive, customers may have to settle for less coverage, higher deductibles and higher co-pays.

Both the city and state bar associations have sent letters to their members explaining how the changes will affect them.

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