Businesses in NJ Look to Insure Workers Through Federal Marketplace

Andrew Kitchenman | December 3, 2014 | Health Care
Federal grant connects enrollment aid with small business employees

U.S. Department of Health and Human Services regional administrator Jackie Cornell-Bechelli.
Federal officials looking for ways to enroll uninsured people are turning toward their employers for help.

The Employer Association of New Jersey and the Community Health Law Project are meeting with groups of small business executives across the state, helping to connect their workers with the federal health insurance marketplace. The U.S. Department of Health and Human Services is providing a $325,000 grant to support the effort.

EANJ President John Sarno said as many as 400,000 state residents with jobs don’t have employer-provided health coverage.

He said that businesses benefit from having employees who have access to healthcare – even those whose owners can’t offer coverage on their own.

“Quite frankly, employers are stakeholders whether they provide insurance or not,” since healthier employees use fewer sick days and are more productive, said Sarno, whose association advises businesses on legal and healthcare issues.

The business outreach is occurring in the context of a broader effort to reach those who didn’t buy insurance in the first year of the marketplace.

U.S. Department of Health and Human Services regional administrator Jackie Cornell-Bechelli said she would be meeting with local business groups along with the EANJ-coordinated effort.

“One of our biggest themes, if I could narrow down our efforts into one quick statement, would be to bring healthcare to where the people are, so we’re trying and encouraging many of our coalition partners to go where the people are already assembled to bring the information and the access to them,” Cornell-Bechelli told a joint legislative task force that is monitoring the marketplace implementation in the state.

Some business owners are realizing that the marketplace can be the “best and most affordable option for the employees,” she said.

Sarno’s meetings with employers began three weeks ago.

“The employers that we have talked to are very enthusiastic,” he said of the meetings.

Some employers have said that workers would prefer to pay the federal penalty for remaining uninsured than pay for coverage, Sarno said. But the comparative advantage of buying insurance could increase as federal penalties climb. While the penalty is the greater amount of $95 or 1 percent of income this year, it’s growing to the greater of $325 or 2 percent of income in 2015 and the greater of $695 or 2.5 percent of income in 2016.

“Eventually that should drive those free riders to get their own insurance,” Sarno said.

The South Orange-based Community Health Law Project provides trained counselors to help the employees of the small business apply for marketplace insurance. The marketplace is one of the primary ways that the Affordable Care Act increases access to healthcare.

While much of the effort targets small businesses, Sarno is looking to meet with some larger employers with part-time or seasonal workers.

“The bottom line is there are a lot of workers without insurance,” Sarno said. He added that while some employers have talked about dropping coverage and allowing workers to move to the marketplace, Sarno hasn’t talked to any who have actually done so. Relatively affordable prices have contributed to this, he said. While Sarno’s association also provides health insurance to businesses, he said that the marketplace outreach is an entirely separate effort.

Sarno added that many small-businesses owners are skeptical of the marketplace due to their philosophical opposition to the ACA. But Sarno added that he’s been able to clear up misconceptions about the law. For example, some meeting attendees incorrectly said that the law provides free healthcare to undocumented immigrants (who are barred from the marketplace and Medicaid eligibility expansion) and that the marketplace is government insurance (it’s provided by private insurers).

“I find that when I get into the weeds, when I’m in the trenches with these groups, most of the philosophical differences are really based on gross inaccuracies,” Sarno said.

Sarno said meeting attendees appreciate his fact-based approach.

“I’m not there to sell the ACA. I’m there to explain how to get their workers covered,” Sarno said.

But Sarno said executives do have a legitimate gripe with one effect of the ACA, which led to the termination of bare-bones health plans that attracted young and healthy people. The end of these plans drew complaints in late 2013, after President Barack Obama had said that those who were pleased with their insurance would be able to keep it.

“A lot of employers offered them to their employees and those reasonably young employees were satisfied with those policies,” Sarno said.

The bare-bones plans were eliminated because the ACA increased the minimum coverage required of individual and small-group insurance plans.

Sarno said that in some ways the second open enrollment period, which began on November 15 and extends until February 15, would be more important than the first open enrollment, which ended in April. That’s because those who were most eager to have insurance signed up in the first year, leaving a more-difficult-to-reach population of remaining uninsured residents.

“This is why they want to do something creative now,” such as the business outreach, Sarno said of federal officials.

Cornell-Bechelli said the federal government is working to recruit businesses in a broader effort to provide residents information about the exchange. She noted that businesses, along with church and other community organizations, have an established, trusted presence in their communities.

“We’re working with Main Street alliances and local chambers to share information in laundromats, in beauty shops, in nail salons, so people are seeing, ‘Hey I have a window of time in which I need to enroll in coverage,’” she said. “It’s just one more reminder to get out there and get covered.”