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Independent contractors and freelancers make up an increasing share of the workforce, yet Washington is largely neglecting the market where self-employed workers get health insurance. That's bad news for people in the burgeoning "gig economy," where work is divorced from an employer — and thus from employer-sponsored insurance.

Expand chart
Reproduced from a Brookings Institution analysis of BLS data; Chart: Axios Visuals

Why it matters: The Affordable Care Act sought to make the individual market more affordable and competitive. Today, though, those benefits are concentrated heavily toward lower-income consumers who get a subsidy to help pay their premiums, and Congress hasn't shown much interest in stabilizing it. But that market will be growing.

Key quote: "Obamacare and the gig economy were a match made in heaven," said the Kaiser Family Foundation's Larry Levitt. "But, with instability and rising premiums in the individual market, especially for people not eligible for subsidies, it’s not as good a solution for gig workers as it was initially."

The big picture: “The future of work looks like its going to be fairly erratic and unstable at times for workers, so we should be preparing for that," said Brookings' Mark Muro, one of the authors of a new post comparing the gig economy to more traditional payroll jobs.

  • Health care is one of the most valuable benefits workers have traditionally gotten through their employers. People who are self-employed or have a job that doesn't offer coverage would turn to the individual market.
"This is a long-term problem we’re not paying enough attention to if the individual market continues to tank.”
— Chris Sloan of Avalere

Yes, but: This may be an area where the Trump administration's health care agenda could help. The administration is expanding access to association health plans, or AHPs, which allow similarly situated individuals to band together and buy insurance almost as if they were a company.

  • “In theory, this Congress ... should enact rules that make the individual market a more functional market and enact rules that recognize the growth of the gig economy. But the political environment in Congress doesn’t permit that," said Chris Condeluci, a health care lawyer and former GOP policy staffer.
  • "So the next best thing…is to come up with alternatives” like the new AHP rule, he continued, “which is more or less serving as another option for independent contractors who are right now stuck in the individual market.”

Some experts caution that these plans are more likely to benefit healthy people, as they could offer less comprehensive benefits than ACA plans. They also could skew towards benefitting urban workers.

  • “It’s the same issue we have in the individual market…it’s the places that don’t have large populations where you’re seeing only one option," Sloan said. "AHPs, they’re not really designed to solve that.”

Go deeper

House passes sweeping election and anti-corruption bill

Photo: Win McNamee via Getty Images

The House voted 220-210Wednesday to pass Democrats' expansive election and anti-corruption bill.

Why it matters: Expanding voting access has been a top priority for Democrats for years, but the House passage of the For the People Act (H.R. 1) comes as states across the country consider legislation to rollback voting access in the aftermath of former President Trump's loss.

Updated 3 hours ago - Politics & Policy

House passes George Floyd Justice in Policing Act

Photo: Stephen Maturen via Getty Images

The House voted 220 to 212 on Wednesday evening to pass a policing bill named for George Floyd, the Black man whose death in Minneapolis last year led to nationwide protests against police brutality and racial injustice.

Why it matters: The legislation overhauls qualified immunity for police officers, bans chokeholds at the federal level, prohibits no-knock warrants in federal drug cases and outlaws racial profiling.

5 hours ago - Politics & Policy

Senate Republicans plan to exact pain before COVID relief vote

Sen. Ron Johnson. Photo: Stefani Reynolds/Bloomberg via Getty Images

Republicans are demanding a full, 600-page bill reading — and painful, multi-hour "vote-a-rama" — as Democrats forge ahead with their plan to pass President Biden's $1.9 trillion COVID-19 relief package.

Why it matters: The procedural war is aimed at forcing Democrats to defend several parts the GOP considers unnecessary and partisan. While the process won't substantially impact the final version of the mammoth bill, it'll provide plenty of ammunition for future campaign messaging.