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Navigating the fog of health care reform

Last month, a group of employers asked me to talk them through what they need to think about when communicating to employees about health care reform. Members of the Employers Health Coalition of Idaho are a thoughtful group who want to stay on top of Affordable Care Act issues. As I began to prepare, I already suspected employees, like most Americans, were confused about the law and how it would affect them. I called the presentation, “The Fog of Health Care Reform” since it is so difficult for all of us to see our way through.

It had been a while since I looked closely at the research tracking Americans’ opinions and understanding of health care reform. As I dug in, I was pretty shocked by what I found. The Kaiser Family Foundation reported in its March Health Trends Tracking Poll that 68 percent of Americans said they don’t have enough information about health care reform to know how it affects them personally. That’s a huge majority of Americans who don’t understand a law that will, in seven months, affect all of us directly. The results of Kaiser’s (just released) April tracking poll left me even more concerned.

April’s poll reported four in 10 Americans are unaware the Affordable Care Act is still the law and is actively being implemented. Of those, 16 percent think it was overturned by the Supreme Court; 14 percent think Congress repealed it; and 29 percent don’t know what happened to it, but don’t think it is law.

Let me be clear on this: The Affordable Care Act is law. My clients are scrambling to comply with its provisions each day as new regulations are issued, and every American will also have to comply with it by Jan. 1, 2014, when everyone is required to have health insurance.

I don’t believe this will be a mystery to Americans much longer. As state and federal exchanges are built out this summer, the carriers that participate are going to aggressively pursue not only the millions of uninsured Americans, but also those currently covered by employers. Their messaging is going to play on the law’s coverage requirement to create a sense of urgency. And it is going to entice individuals with the lure of federal subsidies. If your family income is 133 percent to 400 percent of the federal poverty level, you may qualify for a subsidy. In other words, a family of four making $92,000 a year may qualify. You can expect to see myriad commercials similar to what happens in the fall during Medicare open enrollment.

I expect many conscientious Americans who currently receive employer-sponsored health care are going to be confused by the exchange commercials, not to mention the misinformation espoused on cable television. Even if individuals are pretty confident their employer-sponsored coverage ensures they comply with the law, they will still want employers to confirm that message early and often as enrollment season and exchange marketing heat up in the fall.

The Department of Labor has released a temporary model notice employers can begin using to start this conversation with employees. The notice is intended to inform employees of the health exchange options, and employers must send it out by early October. A final notice should be issued at some point this summer, but DOL says employers can use the model notice now if they feel the need to begin to start communicating.

For employers, the conversation involves more than a government-issued notice. For some, exactly how to position that conversation is tricky, to say the least. As one human resources vice president said to me this week, “Do I really want to be in the business of communicating a government program? That’s not my responsibility.”

While it is true that employers will want to carefully consider how far to go in presenting information about exchange options, employers should also be prepared for the fact that those questions will be coming. Remember, 68 percent of Americans don’t understand health care reform. They’re going to go to the source they know: you, the employer, who gives them insurance already.

So, employer, are you prepared for this conversation and the questions coming your way? I urge you to start getting ready by understanding your strategy for responding to health care reform provisions and how you want to message that to your employee population. You will be able to avoid a lot of distractions this fall if you get ahead of this issue. There is time to prepare, but you need to start now.

Michelle Hicks, a senior professional in human resources, is a director in the communication practice of Buck Consultants, a Xerox company. 

About Michelle Hicks