The sudden death of the legislation to repeal the Affordable Care Act (ACA) was yet another twist in the long and winding road of Healthcare Reform. The insurance industry, business and medical communities, the media and insurance consumers are all asking “What’s next for American healthcare?” To answer that question: we think the spotlight will focus on insurance consumerism.
How far will President Trump and Republicans go to dismantle the ACA through administrative and legal actions? Will there ever be a bipartisan effort to fix the parts of the ACA that don’t work well? Or will the GOP take another run at their bill, the American Health Care Act, to make it palatable enough to pass the House and Senate? And where does that leave the individual insurance consumer?
All we can say for sure is that the healthcare debate is far from over. For now, the ACA is alive and that’s where employers should put their focus.
It’s an uphill climb, to be sure. Only a minority of people understand how insurance works. You probably saw the study: only 14% of users can articulate the meaning of deductibles, co-pays, co-insurance and out-of-pocket maximums.1 If employees don’t understand common terms, they’re not using their benefits wisely. Misuse drives up health & welfare costs for the both user and the employer. Regardless of what happens to the ACA, it’s not a stretch to assume that costs for all stakeholders will continue to rise.
To tighten the spigot on cost, we encourage employers to work with their benefits brokers to develop a comprehensive employee education & communications program that helps the individual understand all aspects of their health & welfare benefits. For example, the ACA replacement bill would likely have expanded health savings accounts. It’s not enough to think that employees will educate themselves on what an expanded HSA program would mean for them, or the consequences of choosing a high-deductible health plan for its low premium. They need guidance now, not a couple of years down the road when the future of the ACA or its replacement is clearer.
Emphasizing insurance consumerism is a chance for employers to empower their workforce.
An employee education & communications program isn’t enough if it’s just a benefits renewal presentation at open enrollment and a few follow-up emails. A comprehensive strategy delivers communications via various channels that take workforce demographics into account. A smart campaign embraces a range of topics. Talk to employees about the services covered by health & welfare benefits, how to use the plan effectively, how to save money on prescriptions, and what those four common insurance terms mean when put into practice.
Don’t forget wellness and disease management. A metrics-bearing health & wellness approach can uncover claims-busting chronic health issues through something as basic as getting an annual exam and blood work. Employees need to know sooner rather than later if they need medical care. This knowledge can help them save money and may even save their lives.
Political pundits, journalists, leaders in the healthcare and insurance industries, and virtually everyone speaking on the matter are merely speculating on the future of healthcare. While the specifics are not clear today, it’s safe to assume that the focus on insurance consumerism will continue to increase, and it needs our undivided attention.
Sir Francis Bacon is credited with coining the phrase, “knowledge is power.” The emphasis on insurance consumerism is a real opportunity for employers to empower their workforce with the knowledge to adapt to a changing American healthcare reality…however that reality manifests.
1Journal of Health Economics, “Consumers’ Misunderstanding of Health Insurance”
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