Leading Individuals for Organizational Health

Today, employees need quite a bit of help staying and keeping healthy in order to live a good life and keep your organization healthy.

But with seismic shifts in the landscape of healthcare costs and options, many employees can get lost in all the confusion.

Costs and Care

The Affordable Care Act has made remarkable strides toward improving Americans’ access to care. Since its 2010 debut, about 16.4 million previously uninsured Americans have obtained coverage. Those gains stem from healthcare marketplace purchases and young adults receiving coverage through parents’ plans until age 26.

According to the Kaiser Family Foundation, while the law has reduced America’s uninsured rate from a little more than 16 percent in 2013 to barely 10 percent today, it hasn’t been so effective at reducing costs — affordable care is still out of reach for many Americans.

A Families USA report found a quarter of insured adults skipped necessary care to avoid costs. The Kaiser Family Foundation cited 48 percent of uninsured adults said care is unaffordable, even though more than 70 percent had at least one full-time worker in their households.

And because so many Americans receive employer-sponsored coverage, businesses are feeling the hurt, too. With the average annual premium for employer-sponsored family coverage reaching $17, 545 in 2015, company leaders are struggling to provide workers with reasonably priced coverage.

Without proper care, workers are less reliable and less productive.

Fortunately, there’s a solution that can significantly diminish the burdens of care for employers and low-income working Americans.

Healthy Options

Medicaid for American Families and Businesses

The ACA expanded Medicaid to those with incomes below 138 percent of the federal poverty level, but it remains underutilized by working families.

Medicaid provides comprehensive coverage comparable to or better than most private plans. Enrollees enjoy minimal to no premiums, deductibles, copays, or pharmacy costs, as well as benefits like vision and dental care, non-emergency transportation, and substance abuse treatment.

When a parent enrolls, their children and spouse are also covered. Unsurprisingly, Medicaid recipients are just as satisfied, or more satisfied, than those with private coverage.

Medicaid expansion has also brought opportunity to business owners. Employers in the 31 Medicaid expansion states can transition eligible employees off of company-sponsored plans and onto Medicaid, freeing up thousands of dollars in premium costs per year.

Get Employees Covered

Business leaders can assist in transitioning eligible employees to Medicaid by following a few simple steps:

1. Arm employees with facts.

Medicaid is sometimes stigmatized as being only for poor, unemployed individuals. However, this attitude is based on misinformation; millions of hard-working, employed Americans receive Medicaid. Clear up misconceptions by providing employees with reputable information:

  • Display comparisons between Medicaid’s costs and the costs of the company plan. For a family on a budget, these costs speak for themselves.
  • Explain that family coverage comes without additional dependent costs; outline Medicaid’s benefits for children.
  • Avoid stigmatizing terms like “welfare” or “charity care,” and answer employees’ questions calmly and factually.
  • Send or summarize studies explaining Medicaid’s benefits to skeptical employees; encourage them to do their own research.

2. Begin with new hires, then expand.

Rather than transitioning all eligible, interested employees at once, have HR first discuss Medicaid with new hires. It’s the perfect opportunity to get happy, compliant workers. Just don’t coerce employees to opt out of the company plan — it’s illegal.

Then, have HR set up one-on-one meetings to help other employees determine eligibility based on income information. If this proves too cumbersome for HR, consider contracting with a third-party enrollment service.

3. Cross the T’s and dot the I’s.

Make sure you, HR, or your third-party vendor follow up with employees after the process has begun.

Offer employees time and resources to complete their application at work — a time when they are much more likely to give their full attention, rather than during off hours. Have HR check that enrollees received mailed Medicaid cards; this part is crucial to maximizing the company’s savings.

4. Assist with annual renewal.

Many Medicaid enrollees don’t realize they need to renew coverage on a yearly basis, and this process leads to significant attrition. This could mean employees end up right back on company plans — an unnecessary financial burden for the employee and the company.

Keep employees covered by alerting them when the renewal period is approaching. Remind them to bring renewal forms to work for assistance from HR or your third-party vendor.

Health insurance enrollment is open until Jan. 31, so now is the perfect time for business leaders to introduce employees to the Medicaid option. Medicaid isn’t something to be ashamed of — it could be your team’s path to better health.

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Benjamin Geyerhahn is the founder and CEO of BeneStream
Benestream guides employers and employees through the Medicaid process
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L2L Contributing Author