"I Can't Leave, I Need the Insurance": How to Leave Academia and Freelance With a Chronic Illness

Is the fear of losing your health insurance keeping you trapped in academia? This worry keeps a lot of chronically ill academics stuck in jobs that are making them sicker—and the premise is worth questioning.

In this episode, Paulina talks with D. Scott, PhD, JD, a former academic who developed a chronic illness during a postdoc at the University of Edinburgh and slowly realized the tenure track wasn't survivable for their body.

Instead of forcing themselves into another job for the benefits, D. chose their health, moved back to the US, and built a freelance academic editing business that's now in its sixth year and booked through December.

D. gets honest about the stuff nobody explains:

⚕️ how to research which states give you real support,

⚕️ why freelancing gave them more flexibility than any "stable" job ever did,

⚕️ how they pace work around an unpredictable body, and

⚕️ why raising your editing rates matters most when you physically can't work more hours.

In this conversation, we also cover:

👉 Why the fear of losing health insurance is more workable than the worst-case stories suggest

👉 How to schedule and book clients when your energy isn't guaranteed

👉 How to stop assuming clients think about money and deadlines the way you do

👉 The chronic-illness and disability editor communities that make this work less lonely

If you've been telling yourself you're stuck because of your health, you absolutely have to listen to this episode.

▶️ Hit subscribe so you don't miss the next conversation.

To work with D., get in touch here: dscottedits.com

For more on building a freelance editing or coaching career after academia, visit AcadiaEditing.com/map

Resources Mentioned:

📌 Northwest Editors Guild — monthly "Editors with Chronic Illnesses, Disabilities and Neurodivergence" Zoom call (open to non-members; sign up through the Guild's website calendar): https://www.edsguild.org/meetings-events/

📌 LGBTQ Editors Association — Slack community with a dedicated chronic illness, disability, and neurodivergence channel: https://lgbtqeditors.org/

📌 Resources to research marketplace options and health insurance brokers:

https://www.kff.org/affordable-care-act/state-indicator/state-health-insurance-marketplace-types/

https://www.healthcare.gov/find-local-help/

Timestamps:

00:00 Why chronic illness and freelancing comes up so often

04:30 D.'s path: the PhD, Edinburgh postdoc, and getting sick

09:00 Letting go of the tenure track

13:30 Researching states, Medicaid, and choosing New Mexico

18:00 Landing as the pandemic hit, and why editing was the plan

22:30 The health insurance reality: Medicaid, marketplace, and brokers

27:00 Choosing health over career and a new relationship to work

31:30 Scheduling around an unpredictable body

36:00 Money mindset: boundaries and raising your rates

41:00 Finding your people: chronic-illness editor communities

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