The gig economy continues to grow, offering workers flexibility and control over their schedules through apps like Lyft, DoorDash and Airbnb. For many gig or independent workers, quality health care is becoming increasingly unaffordable as insurance premiums rise and traditional benefits remain out of reach.
"Even the same insurance company that I've been with every year, the cost has gone up," said Alisa Hazle, who manages over two dozen Airbnb properties with her husband, Keith.
The married couple entered the gig economy several years ago and initially went with little to no health coverage, mostly paying out of pocket.
"You're not really making any money, so you can't afford it," Keith Hazle said.
Now parents, the two entrepreneurs say they need quality health insurance. They are part of a growing number of independent workers who rely on gig work for their primary income but don't receive traditional benefits or qualify for Medicaid, and are turning to government marketplaces where millions of Americans are now experiencing sticker shock.
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Across the board, enrollees will see an average 26% increase next year, with some states seeing astronomical increases if enhanced premium tax credits expire.
"The primary factor that's driving premiums so much higher is the impending expiration of the subsidy enhancements," Louise Norris, a health policy analyst with healthinsurance.org, told Scripps News. "For people who get a subsidy in the marketplace, which is nearly everyone, the average premium increase is more than 100%."
"Health insurance premiums will go up about $1,000 a year for the typical person," economist and MIT professor Jonathan Gruber said. "So many people will lose their health insurance if these subsidies go away."
Gruber said one of the biggest barriers to self-employment in America is the lack of health insurance.
"People might not want to strike out on their own because they're afraid of being uninsured. The ACA helps solve that problem, in particular with the buying subsidies," he added. "And with that gone, people might be afraid to take risks."
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"It's a tricky year," Alexa Irish, co-CEO of Catch, an online platform that helps independent workers navigate Affordable Care Act marketplaces and state exchanges, said. "There's a lot of unknowns this year."
"Our advice to everyone is really to shop early, to look at all your options, and not to stop shopping this year," Irish said. "I would never recommend you go without coverage because one medical emergency can put you in a really tough spot from a cost and debt perspective."
For health insurance shoppers like the Hazles, the risk of going uninsured is not an option.
"Now that we have a daughter, right, we're going to actually make the investment of ensuring that we both have insurance," Keith Hazle said.
"We've made it a necessity. Like, it's imperative, like we have to have it. So we are going to make room for it in our budget," he added.