Communicating healthcare reform: Helping navigate the waters

Communicating changes due to healthcare reform can be a challenge for employers—reform-driven changes have a sweeping impact, an uncertain future, and can be politically charged.

For years, employers have turned to us for help communicating open enrollment, rolling out new plans such as consumer-driven health plans, and explaining the high cost of healthcare to their employees. Communicating healthcare reform issues is a natural extension; it’s our job to navigate those waters so they can concentrate on the program’s strategy.

The next wave is about to hit

Since the Patient Protection and Affordable Care Act (PPACA) was signed into law in March of 2010, there has been an occasional flurry of communication activity related to a few plan changes (extending dependent coverage to age 26, eliminating lifetime limits, and eliminating preexisting condition exclusions for children, to name a few). In addition to enhanced preventive care for women and FDA-approved prescription contraceptives, this fall employers will need to communicate the lower healthcare flexible spending account contribution maximum of $2,500 that goes into effect January 1, 2013. Given that most employers had a $5,000 maximum, this change will be widespread. Of course, employers are looking down the road at even more significant changes in the near future.

This spring, employers will be required to notify their employees of the exchanges—state run healthcare plans from which individuals can purchase insurance. Starting October 1, 2013, individuals and employers with 50 or fewer employees (or 100 or fewer employees at each state’s option) can start purchasing health insurance plans on the state or federal exchanges for coverage effective January 1, 2014. The expansion of Medicaid will create yet another level of complexity for employers as more of their lower-income employees become eligible in 2014.

For certain employees, these changes open up a whole new array of healthcare possibilities–and a potentially overwhelming set of considerations. While the biggest impact will be on lower-income employees, employers should be prepared for confusion among all segments of their employee population beginning with the exchange announcement in 2013. This rollout of public exchange availability will continue through 2016 (for employers with 100 or fewer employees, if not previously eligible in their state) and 2017 (for large employers). All along, employees are, and will be, wondering what’s coming and what do they need to do. Employees will be confused and they’ll turn to their employers for information.

As employees try to understand their options in newly charted waters, we anticipate employee questions such as:

• Can I get coverage through the exchange?
• Am I eligible for Medicaid?
• Do I have a choice between the exchange and my employer’s plan?
• Do I get a subsidy?
• Can I use my subsidy to pay for employer-provided health coverage?
• Can I have employer coverage as well as coverage through the exchange?
• Are my dependents covered through the exchange?

Employers who take a proactive approach to addressing these questions can help guide choices in ways that are best for both employer and employee.

The role of personalized communication

What role will personalized communication play in future healthcare communications, if any? It may be a logical solution depending on the situation. Employers will need to determine if they will incur a penalty related to employee exchange subsidies, and to do that, they will need to know who is likely to be eligible for a subsidy. We can take that same information and create individual statements that clarify the subsidy amount for the individual, lay out the decision points, and clearly identify the options available to the employee.

Set the right course

We’re not entirely sure how employers will respond down the road. A number of our clients are working with our Milliman consultants to conduct a Healthcare Reform Strategic Impact Study, which determines how healthcare reform will affect their population.” The results of these discussions will influence the direction that their communication should take.

Employers will need to make strategic decisions about whether or not they want to offer employees affordable health insurance. If they do not offer affordable health insurance, they would be subject to a penalty if any employees receive a subsidy in the exchange.

Independent of the strategy that employers choose, they are best served by taking a proactive approach. It will be important to set a strategy to communicate healthcare reform changes and do it in a way that ensures employees have the right information at the right time and the overarching benefit program goals are met.