Health Care

The Future of Work and the Affordable Care Act

October 31, 2017  • Natalie Foster

American workers deserve to have health coverage regardless of their employment status. For years, if you didn’t work for an employer that offered health coverage, you were out of luck. The Affordable Care Act changed that for millions of people, and created the opportunity for independent workers to finally access quality health care. As work continues to change and more people work outside of traditional employer-employee relationships, the viability and success of the Affordable Care Act becomes increasingly important.  

The GAO estimates that 40 percent of the American workforce had an alternative work arrangement in 2010, due to the fissuring of the workplace, the rise of temporary work and other changes. According to economists Alan Krueger and Lawrence Katz, the share of workers in alternative work arrangements increased by more than half between 2005 and 2015, and these 10 million new contingent jobs accounted for 94 percent all of the net new job growth during that time period. While the emerging platform economy, or gig economy, accounts for a small portion of that work, it’s a part of the workforce that’s growing by 47-fold over the last three years.

Tomorrow marks the beginning of Open Enrollment season for the Affordable Care Act. Unlike previous years, the enrollment season only runs from November 1st to December 15th, highlighting the importance of spreading the word to those who need health insurance that now is the time to sign up.  

A coalition of tech companies plan to engage those who work on their platforms about Open Enrollment. Platforms like Fiverr,, DoorDash, Etsy and Postmates will be using email and in-app notifications to remind the independent contractors on their platforms of the opportunity to purchase health insurance — reaching 3.5 million people. Uber is alerting nearly a million possibly eligible drivers as well, including holding in-person information sessions at 28 of their the physical spaces where their drivers meet up.

Althea Erickson, Global Head of Advocacy and Public Policy at Etsy explains why:  “Open Enrollment offers our sellers the opportunity to access health insurance and critical subsidies outside traditional employment, which is increasingly important for the millions of people working independently in the United States today. That’s why we we’re helping our sellers connect with the information they need to find and enroll in affordable coverage.”

We know this part of the American workforce already relies on these markets for health insurance. According to data from the Department of Treasury, at least one in five customers of the Health Insurance Marketplace are small business owners. From making healthcare more affordable to this group, to allowing new college grads to stay on their parents’ insurance as they tinker with market-shaping innovations and ideas in early-stage programs like Y Combinator, the Affordable Care Act supports entrepreneurs in our economy.

One of those small business owners is my father, who recently relocated to Colorado and hung out his shingle as Foster Handyman. He generates some of his leads through websites like Thumbtack, a marketplace for local services, and others he generates the old-fashioned way, by word of mouth. My parents’ move to Colorado to be near their grandson — and my father’s new business —  was only possible because they could afford health insurance, thanks to the Affordable Care Act.

My dad isn’t alone. Here’s Marco Zappacosta explaining what Thumbtack pros are worried about from a poll earlier this year: “The bottom line is that a clear majority of pros [71 percent] think the federal government should help all Americans access affordable health insurance.”

For now, the ability to access health coverage will exist for workers in most states — but survival of the marketplaces will depend on people using them. And in order to use them, people need to know about them. Kudos to the tech companies who are encouraging their workforce to sign up, and other efforts to raise awareness about this year’s Open Enrollment period.