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The issues dominating the dual Hollywood strikes by actors and writers are artificial intelligence, residual payments and job protections. But one topic that's often a contentious point in labor negotiations – health insurance – has slipped under the radar.

A-list stars have been out in force snapping selfies on picket lines in the bright California sun, but it's the people who may have never walked the red carpet who are forgoing a paycheck and potentially their health insurance as the negotiations drag on and work dries up.

The health insurance offered by both unions is predicated on the notion that it is for members who work consistently and lucratively enough to make a minimum amount of money. That makes the insurance difficult first to attain and then to sustain. In exchange, it is very, very good health insurance.

Holdover from a bygone age

Often referred to in hushed, reverent tones as the "Cadillac of health insurance" by those who have it, the policy offered by the screenwriters guild, for instance, feels like a holdover from a bygone age. It has no monthly premiums, costs $600 per year to cover the rest of your immediate family and has deductibles that are in the hundreds – not thousands – of dollars.

But the biggest strike in more than six decades in Hollywood threatens that security. The Writers Guild of America has been on strike since May 2, and the actors' union, SAG-AFTRA, since mid-July. Together they represent over 170,000 workers, who refuse to perform any part of their job after talks with studios and streamers stalled. Writers and actors could lose their eligibility for insurance simply because they aren't working while striking.

"If we're this close not to not having it [health insurance] then we're already on a razor's edge, which is kind of why we're striking, even though in the short term it sort of just shines a light on the problem," said filmmaker and Writers Guild member Susanna Fogel.

Complicated formula for writers

For writers to qualify for health insurance, they must earn a little over $41,700 in covered union work a year and residuals don't count. The income requirement continues to rise, which coupled with the increasingly uncertain reliability of employment means even experienced writers can have a hard time qualifying.

Writers can accumulate credits by qualifying for WGA health insurance for 10 years and by earning more than $100,000 in covered work. Top earners can rack up three points per year, which can then be cashed in when writers experience a dry spell and can't make the minimum income requirement, but health coverage ends the quarter after the credits are used up.

For example, a writer who qualifies for health insurance for 10 years but earns less than $100,000 can cash in all their points and continue their insurance for up to a year and a half if they are only insuring themselves.

But insuring dependents costs more credits, meaning people with families have less of a stop-gap to fall back on.

As the strike stretches on into another quarter, many union writers are furtively calculating how many credits they have and how long this temporary measure will buy them, if they have credits at all.

Actors' good deal is precarious

In contrast, residual payments do count toward the $26,000 per year that SAG-AFTRA members must earn to qualify for health insurance offered by the actors' union. This makes increasing residual payments especially from streamers like Netflix a high priority for members who are on the margins.

Plan premiums from SAG-AFTRA are $125 per month for union members. For a family of four or more, the monthly cost rises to $249 per month or $2,988 per year. That's less than half of the $6,680 that the average California worker with employer sponsored health insurance paid for family coverage in 2022, according to a report by the California Health Care Foundation.

Members of both unions say it took them years to make enough money to qualify for the union health insurance, while other union members who have worked in the industry for years never have.

"The moments that I've been at risk of or have lost health insurance in the past, pre-strike, were when I was working," said filmmaker Fogel, who is also a member of the Directors Guild of America. "I was working, but there were particulars to the work that just made it fall short or fall in the wrong month to stay covered. So it was just always a stress."

Should the unions simply drop the income requirement to a lower amount so more members could qualify? Alex Winter, a longtime member of three industry unions, doesn't think so.

"It seems draconian to turn back to the unions and say, 'Well, since we have these oligarchs who are hoovering up all the profits, let's try to take what few squirrel nuts we have and scatter them out amongst whoever survived staying in the industry,' as opposed to fighting to get equitable pay, which is what we're doing," Winter said.

Both SAG-AFTRA and WGA were approached for interviews about their health insurance offerings. SAG-AFTRA declined to be interviewed and WGA sent LAist a link to their FAQ page.

A new California law could help strikers on the margins

All California workers who lose their employer-sponsored health insurance may be eligible for the state's Medicaid program, known as Medi-Cal, or qualify to buy health insurance through Covered California, where their costs could be low if they have minimal income. Still, it would be a disruption to lose their low-cost SAG-AFTRA or WGA plans, and an additional expense at a time when striking workers are making much less money.

Writers and actors who lose their union health insurance as a result of the strike could benefit from a new California law that took effect July 1, 2023 aimed at averting just that situation.

AB2530 received $2 million in funding under the new state budget. To qualify, a union worker must first lose coverage as a result of the strike. According to Covered California spokesperson Craig Tomiyoshi, eligible workers will have their premiums covered as if their incomes were just above the Medicaid eligibility level.

Not all striking workers will enroll in a free plan. Striking workers will be able to pick plans that are more expensive than the benchmark plan. If they do, they will pay the difference in premiums.

"Covered California has seen fewer than 150 applicants who have identified an affiliation to WGA or SAG-AFTRA apply for coverage," said spokesperson Kelly Green in an email response. She added they expect to see more if the strikes continue and people anticipating losing their union health insurance should get in touch.

Beginning Jan. 1, 2024, another law kicks in. Covered California will end deductibles on the middle-tier benchmark plans, meaning a striking worker could receive free premiums under one law and no deductibles beginning in the New Year, if the labor dispute lasts that long.

Crews left out

The new law doesn't cover crew members who are not part of the striking unions but have lost health insurance due to the work stoppage.

A new mutual aid group was created to fill that gap.

The Union Solidarity Coalition known by the acronym TUSC has raised more than $315,000 to give assistance to International Alliance of Theatrical Stage Employees and Teamsters members, said founding member Alex Winter.

"I don't know anyone, honestly, in a lot of the primary crew areas who isn't in danger of losing their health insurance, and I know a lot of people who have lost their health insurance," Winter said.

The idea for the non-profit began with conversations between crews and filmmakers, said fellow founding TUSC member and filmmaker Susanna Fogel.

"Because their coverage is based on the hours that they get within a certain window of time, some of the [crew members] mentioned they or people they knew were at risk for not making their hours due to productions shutting down, or if they opted not to cross a picket line, that could cost them their health insurance," she said.

TUSC has partnered with the Motion Picture and Television Fund and its Entertainment Health Insurance Solutions, which acts as an insurance navigator for people in the industry.

Fogel says it's about making sure that everyone in the industry has access to high quality health care no matter the current industry conditions.

"Every so often when there's one group of people that are going on strike and it's our turn to strike right now, we just wanted to kind of let the other unions know that we consider ourselves to be part of a collective and we hope that they feel that love from us," Fogel said.

Could studios and streamers continue coverage?

They could, but it's unlikely.

In July, Matt Loeb, president of IATSE, the union that represents behind-the-scenes workers, called for studios and streamers to offer an extension of health care benefits to those who may lose them if they fall short of qualifying during the strikes. IATSE is not on strike.

"Make no mistake — if the studios truly cared about the economic fallout of their preemptive work slowdown...they could continue to pay crewmembers and fully fund their health care at any moment, as they did in 2020 during the onset of the COVID-19 pandemic" Loeb wrote.

Half of the trustees of the Motion Picture Industry Pension & Health Plan are represented by companies involved in the strike. The WGA's strike FAQ tells members "there is no Health Fund requirement that the Health Plan extend health insurance coverage during a strike, and Trustees are 50% management and 50% Guild."