For Mike Morucci, 50, the idea of leaving his information technology job and its health benefits is "terrifying," he said.
But he decided to take the plunge after reviewing the range of coverage available at different price points. Tax credits will help those with moderate incomes pay their insurance premiums. And coverage is guaranteed even for those with pre-existing conditions. Twenty-five states also agreed to expand their Medicaid programs, providing health care for more low-income people.
"It definitely freed up my thinking when I thought, 'Do I want to give this a go?'" Morucci, of Ellicott City, Md.
Morucci has been writing scripts at night and on weekends for four years and is on a team of writers for a web-based comedy series titled "Click!" launching this spring. Before giving notice at the job he had held for 18 years, he made a spreadsheet of health plans available on the Maryland exchange and found one for $650 a month to cover him and his 23-year-old daughter.
"I turned 50, so for me it's time to focus on my passion instead of my paycheck," he said.
The United States has been unique among industrialized nations in tying insurance and employment closely, said labor economist Craig Garthwaite of Northwestern University, who co-authored a frequently cited study on how the health law may break what's known as "job lock." Even in Germany and Japan, where insurance remains private, people who can't afford it get public assistance and coverage is guaranteed.
Job lock "forces people to work at jobs that are not suited to their talents just to get benefits," Garthwaite said. "Economists tend to think that's a bad thing."
In congressional testimony this month, Health and Human Services Secretary Kathleen Sebelius said that "people will have some choices that they don't have today" including farm families who "will have the choice of not having to have an off-farm job to get health insurance for the family."