Mary R. Grealy President Healthcare Leadership Council December 11, 2007 Finding Health Insurance:...
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Transcript of Mary R. Grealy President Healthcare Leadership Council December 11, 2007 Finding Health Insurance:...
Mary R. GrealyPresident
Healthcare Leadership Councilwww.hlc.org
December 11, 2007
Finding Health Insurance: The Ins, The Outs and Lessons
for Policymakers
National Congress on the Un and National Congress on the Un and UnderinsuredUnderinsured
Healthcare Leadership Council
• Consortium of leaders from all health care sectors• Shared vision of a health care system defined by
accessibility, affordability, quality and innovation• No greater priority than accessible health coverage
for all Americans
Understanding the Uninsured
• Is the problem so large as to be insurmountable?
• Breaking down the 47 million uninsured– 11 million eligible for SCHIP,
Medicaid, but not enrolled (“uninsured in name only”)
– Approximately 18 million have annual incomes of more than $50,000
– Approximately 10 million non-citizens
NMThe State Coverage Insurance (SCI) is a public/private partnership offers affordable health care coverage to
eligible low-income working adults
• All you have to do is sign up for SCI if you are 200% FPL or lower
• Employees pay $0-$35 of their monthly premium
• Employers pay $75 of the employees monthly premium
NVThe Nevada Health Insurance Flexibility andAccountability (HIFA) waiver
• The waiver provides up to a $100 per month, per parent (maximum of $200 per family) to help offset costs of the insurance premium payment (must be employed with an eligible employer).
• Not as easy as just signing up employers have to meet more stringent guidelines to be eligible for the program for example:
• Employers must pay 50% of their employees’ monthly insurance premiums
• Employer must sponsor a group health plan
Take up rate = 50% Take up rate = .01%
Quasi Private Programs• Well structured subsidy
– Leverage employer, employee and private dollars– Must be coupled with outreach
Understanding the Uninsured:Most are in the workplace
• 80 percent of the uninsured are in wage-earning households
– Half are not offered coverage by their employer
– Half are offered insurance, but decline either self or family coverage
• Percentage of premiums covered by employers has stayed stable for years
Working and Uninsured: Why?
• HLC commissioned research by Atlanta-based Schapiro Group– National public opinion survey of target uninsured
populations (young adults, families with children, Latino Americans, small business owners)
– One-on-one in-depth interviews– Simulation experiment using different stimuli to encourage
people to seek coverage info
Obstacles to Acquiring Coverage:Preconceptions about cost
• Research shows that many don’t pursue coverage because they believe they can’t afford it.– 66 percent said they cannot afford health coverage,
although most couldn’t say how much it cost
• Previous published research showed this to be true of small businesses also
Obstacles to Acquiring Coverage:Lack of Information
• People generally do not know how to find information on health coverage– 54 percent said they did not know a reliable source of
information– Among those who said they knew where to look, a
majority cited the Internet or friends/family members
Obstacles to Acquiring Coverage:Buyer Resistance
• Interviews show:– The healthy uninsured feel
no immediate, compelling need to buy health coverage
– Seniors would enroll in Medicare Part D coverage when shown program facts; same is not true of health insurance
– Needle does not move without repeated, persuasive contacts
Testing the Effectiveness of Outreach: Health Access America
• A campaign seeking answers to key questions:– Can we significantly reduce the uninsured rolls, using
existing resources?– Can a targeted education/enrollment initiative reach
and convince uninsured Americans?– What are the most effective strategies for overcoming
obstacles to coverage?
The Health Access America Concept
• Launch a campaign dedicated to health coverage education and enrollment– Build broad-based outreach coalitions– Conduct information and enrollment activities– Use local events to bring greater visibility to the issue of
the uninsured– Offer both public and private alternatives
Targeted Populations
• Small business employers and employees
• Young adults• Children• Latino Americans
Campaign Activities
• Grassroots education and enrollment
• Advocacy and education• Earned media• Partnership building• Research and polling
Pilot Sites:Las Cruces, NMRaleigh, NC
The HAA Target Sites
Criteria for Target Communities
• High uninsurance rate• Growing number of uninsured• Affordable insurance products available• Key partner groups on-board• Geographic diversity
Effective Health Coverage Outreach:Important Lessons Learned
• Building strong grassroots partner networks is critical– Establish credibility– Built-in means to drive
people to events
• Leverage events and activities already taking place
• Create one-on-one interaction between attendees and coverage experts
Effective Health Coverage Outreach:Important Lessons Learned
• Utilize media to build credibility, generate attendance, educate public on issue
• Simplicity is critical – make materials, website clearly understandable
• Engage independent brokers – provide variety of plan options for individuals, small business owners
Health Access America:Policy Impact
• Outreach works!– Despite initial resistance, one of every two people who came in
contact with HAA campaign acquired coverage
• Congress needs to follow through on legislative initiatives to invest dollars in outreach activities
• Emphasizing both public and private options enables outreach to more uninsured
• Communities can emulateeffective approaches
• A well-structured subsidy works