‘Shocked, Hurt and Angry’: SAG-AFTRA Health Plan Overhaul Spotlights Broken U.S. System (Column)

Courtesy of SAG-AFTRA

Heather Jones feels “lost, tired and hopeless.” Work has been slow for her and her husband, both actors, since the coronavirus pandemic shut down film and television production five months ago. Last December, their 4-year-old son Harmon completed a series of surgeries, chemo and radiation for alveolar rhabdomyosarcoma, a rare and aggressive cancer, and is now undergoing physical therapy as well as routine MRIs, CT scans and bloodwork in the aftermath. His older brother, Win, has had therapy to deal with the emotional toll of Harmon’s illness.

The family is joyous that Harmon survived. But the fresh changes to their union-provided health insurance that the SAG-AFTRA Health Plan announced Aug. 12, raising premiums and increasing the minimum earnings threshold to qualify for insurance by 44% to $25,950 — in the midst of a global health crisis, on the heels of their youngest’s battle with cancer — has left them “shocked, hurt and angry.”

With production at a standstill, Jones says there is no way they can meet that new earnings minimum, which goes into effect in the new year, fewer than than five months from now. If they lose their union insurance, she will have to find a new way to pay medical bills that could run into the hundreds of thousands of dollars.

“The threat of losing insurance makes me feel untethered,” Jones tells me. “Having a child with cancer is the worst stress; you feel like a balloon that will burst at any moment, so that adding this level of uncertainty and worry is excruciating. It could mean my son’s life.”

She is one of nearly 20 SAG-AFTRA members I spoke to in the wake of the changes, most of whom were blindsided by the news. Nearly 15,000 people have signed a petition to overturn the plan’s revisions; a virtual town hall event last Friday night ran for eight hours as more than 460 gathered to share their concerns. Many worry about whether they’re going to lose their health insurance in an environment in which few are working.

I understand their anxiety on a personal level, as someone who has been married to an actor for nearly a decade and, at least until the changes take effect, is still covered by SAG-AFTRA health insurance. (I’m also an inactive member, having once briefly explored broadcast journalism.) Hollywood is a tough industry to feel sorry for, with its gloss of glamour, but what many don’t understand is that a performer’s life is one of endless hustling, punctuated by occasional victories. For your average middle-class actor, there are bad years and good years: a recurring role here, some voiceover work there, and if you’re really lucky, an (increasingly rare) national commercial to tide the family over for a while.

My husband has been fortunate enough to have had far more good years than not, and his annual pronouncement that he has earned enough to qualify for health insurance is always a welcome one. From my days as an uninsured, undocumented freelancer who had to rely on the good graces of the local free women’s clinic, I know that the great doctors and excellent, low-cost care that come with SAG-AFTRA insurance are an incredible privilege — insofar as one considers healthcare a privilege and not a basic human right. In a country in which health insurance is linked to employment, I don’t know of many other professions that offer that standard of care at that minimum income threshold.

But the changes were sudden, and multifold: eliminating the second-tier plan with a lower income threshold, discontinuing “age and service” eligibility (which allowed actors over 40 with at least a decade of credits and annual earnings of at least $13,000 to qualify for insurance), bumping working spouses off primary coverage, and for performers 65 and older who are taking their pension, limiting eligible income to sessional earnings and not residuals. Those who no longer qualify can continue their coverage through COBRA, which has a $20,000 earnings threshold, still nearly $2,000 higher than the previous Plan 2 minimum.

“You’re going to do this now, in the midst of the pandemic?” asks actor Jennifer Esposito. “Actors have to meet quotas in our work to be able to get health care – and no one is working. How are you doing this with a straight face and be able to sleep at night? It makes me so deeply sad. I don’t know when we’re going to realize that unless we’re all doing okay, then none of us are doing okay.”

She says she will likely be fine, but “it’s not only about me. It’s about my neighbor, it’s about the people that have paid into their health insurance for years and years and years, and now they’re 65 or retired, and they have to get their minimum quota to get health insurance. And you’re telling them this in a pandemic? It is obscene. I’m so upset.”

In webinars to membership this past week, SAG-AFTRA national executive director David White and several Health Plan trustees (the union and the health plan are separate organizations) spelled out the troubles that the health plan encountered as COVID-19 struck, tripling deficit projections for 2020 to $141 million. That follows two years of deficits at or around $50 million, in the wake of the merger of SAG and AFTRA, that had already led to benefit changes at the start of 2020 and reserves that had shrunk by about 20%, or $100 million.

Without major structural changes, the union’s health plan would have run out of reserves by 2024, explained SAG-AFTRA Health Plan CEO Michael Estrada on a three-hour-long informational Zoom conference with members on Monday. Of the union’s 160,000 members, around 33,000 members and 32,000 dependents rely on the Health Plan’s insurance; the changes will translate to about 10% — or 3,300 participants and 2,700 dependents — losing coverage.

Seniors in particular will be impacted by the overhaul: around 8,000 senior performers and 4,000 dependents will have to transition to the provided Via Benefits Medicare marketplace to supplement Medicare coverage. Leadership says the new plan translates to expanded choices for retirees, as well as a new health reimbursement account, but many seniors are concerned about what that means for them. And it has left a bad taste in the mouths of younger actors.

“Our senior performers are the reason we have good healthcare,” says actor Bojana Novakovic, recently a lead on CBS’ “Instinct.” “They worked their lives, paid dues, and made our insurance what it is. In ‘saving’ our plan — aka saving profits for the insurance companies and saving their own salaries — David White and the trustees have betrayed the most loyal, and now most vulnerable, members of our union.”

Actors Pamela and Nicholas Guest (younger brother to director Christopher Guest) have been card-carrying union members since the mid-1970s, and will be eligible for SAG-AFTRA health insurance for another year. But the couple does not know what happens after that. Nick, 69, is taking his pension and is unsure if the current environment will offer enough work to meet the health plan’s sessional requirement, i.e. income from jobs booked and shot during the year.

Like many actors, he relies on residuals from past work to contribute to his annual income. The new requirements mean that residuals will not count toward his eligibility for health insurance, but will likely still count against him in assessing how much he has to pay for Medicare. He, in turn, is concerned about the impact of the plan on the next generation of performers, such as his daughter.

“An actor who’s starting out, I really fear for them,” says Nicholas Guest.

A growing point of contention among members centers on SAG-AFTRA’s most recent agreement with the Alliance of Motion Picture and Television Producers, which was negotiated over the spring and early summer. That master contract for film and television work ultimately included a 2% increase to SAG-AFTRA’s pension and health funding, which translated to $54 million in additional monies for the health plan.

That increase “was a reflection on the fact that the health plan is an absolute priority, and that the health plan needed money,” White told union members on Monday’s webinar.

But several members of the contract’s negotiating committee told me that while they knew the union’s health plan was stressed, they were not clued into just how badly it needed help.

The difference in being told the plan needed funding vs. being told the plan was in such dire straits that it might need a massive restructuring is “a Grand Canyon apart,” says one committee member. This person added that “it would have absolutely, unequivocally affected how negotiations were prioritized,” such as syndication and other elements on the bargaining table.

Another noted that fellow negotiating committee members White and SAG-AFTRA chief contracts officer Ray Rodriguez are also health plan trustees and therefore have a fiduciary responsibility to the plan and to the membership.

“There’s an obvious conflict of interest if they can’t tell us that the plan is about to face a $141 million deficit,” says that committee member.

Sources familiar with changes to the plan say that there is no such conflict of interest, that trustees did not receive a reliable forecast of the deficit until later in the negotiations, and that communicating the new deficit projections to the committee would not have changed the need to make massive structural changes to the plan. The resulting 2% pension and health increase could have been multiplied three or four times and still not have addressed the double-digit increase to healthcare costs that the plan faced, they say.

(In a statement offered to press, the SAG-AFTRA Health Plan said that its trustees have taken a “difficult but necessary action to address financial deficits facing the plan,” due to rising healthcare costs that have been exacerbated by the pandemic.)

Bob Glouberman, who has been acting for 25 years, says he was initially “incredibly angry” at the union. His wife and daughter both have preexisting conditions, and he laments the loss of age and service eligibility. But attending the webinar at least helped him understand the depth of the health plan’s financial straits and gave him sympathy for its plight. And longtime member Becca Lish, who has been able to cover her family of four under union insurance for 30 years, appreciates how inexpensive and comprehensive coverage has been over the years and says the trustees have her “respect and gratitude.” She knows her expenses will rise but doesn’t believe it to be unfair, given the economic circumstances.

But not everyone is so forgiving of the changes. Another tweak to the plan is that out-of-pocket maximums will be eliminated for out-of-network providers. For certain groups of actors, that is particularly alarming.

Marie Fink, a 15-year SAG-AFTRA stuntwoman and member of both the stunt national board and L.A. local board, says that the profession’s years of severe wear and tear on the body often mean that stunt performers require expensive specialized care and specific treatments frequently considered out of network. She also contends that some union contracts disregard necessary safety measures for stunt performers.

“The failure to address the specific needs of stunt performers and the new incongruent requirements to attain coverage, that is less comprehensive and yet more costly, only magnifies the inadequacy of the new health plan,” says Fink.

Others emphasize that this is a matter of union accountability.

“I think there needs to be much more transparency, much more opportunity for participation,” says actor Sophia Bush. The “Chicago P.D.” and “One Tree Hill” actor wants to see more cross-union collaboration with writers and directors, “major changes” to leadership, and less secrecy.

“It’s high time we understood the inner workings of the union, and I think that we need our union to take a tougher stance and draw a line in the sand and refuse to give up protections we’ve won in the past,” she added. “We are not supposed to throw members out of our lifeboat to pull other members in. We’re supposed to be acquiring more lifeboats.”

All told, the collective shock and dismay in reaction to the sudden changes are unsurprising, and perhaps indicative of insufficiency not just with any one particular plan or organization but of a greater, convoluted healthcare system that insists on tying insurance to employment. I’ve spent enough time in the waiting rooms of free clinics and Beverly Hills doctors’ offices to have experienced firsthand the disparities in how we care for those who happen to have a full-time job and those who do not.

That it took a global pandemic to sharply force into view the thin buffer between the haves and the have-nots — and how quickly one can descend into the latter category — maybe means we don’t just need more lifeboats, but a whole new ship.