Huizenga Renews Efforts to Expand Small Business Health Insurance Program

Jeff Fortenbacher believes Access to health is ready for the national stage and to help the smallest of America’s small businesses afford employee health coverage.

If Congress were to enact legislation providing funding to prove it, Fortenbacher sees Access Health as a national model to be replicated in communities across America by providing affordable coverage within reach of employers and their employees.

Jeff Fortenbacher, Bill Huizenga

“It’s a solution,” said Fortenbacher, CEO of Access Health, which for more than 20 years has provided low-cost, basic coverage to small businesses that were previously unable to afford it and employs generally low-wage people.

“I know it will work,” he said. “We have demonstrated that it works.”

Access Health uses low-cost premiums paid for by both employers and employees, as well as federal Medicaid funding that is channeled through the state, to support coverage that is typically purchased by small businesses in low-cost industries. low salaries.

Small employers enrolled in Access Health currently pay $70 per month per employee for basic coverage that comes with low copays and zero deductibles that often prevent low-income people from affording health insurance. Employees pay the same monthly premium, and an additional $70 comes from federal Medicaid funding that goes to healthcare providers.

However, Access Health coverage is limited and only suitable for local care providers in Muskegon County and northern Ottawa County.

US Representative Bill Huizenga, R-Zeeland, plans to reintroduce federal legislation soon that would require the US Department of Health and Human Services to fund three to four pilot programs across the country to test the model behind Access Health, as well as to expand the program in West Michigan.

“It’s an innovative way to solve a real problem,” Huizenga said at a recent press conference at the Access Health office in Muskegon. “We know it’s going to save money, but it’s also – perhaps more importantly – going to provide care.”

Fortenbacher points to actuarial data showing the health plan provides coverage at 55% lower costs than health coverage purchased on an exchange that complies with the federal Affordable Care Act.

Key to this outcome is an intense focus on wellness and health prevention, the management of costly chronic conditions, and holistic services that seek to address the social determinants of an individual’s health, such as their financial, family life or connection to work.

Fortenbacher sees the model not just as a means of providing basic coverage that allows people to access care when needed, but as providing a “transitional pathway out of poverty” and leading people to economic independence.

“We’re either going to have a whole bunch of people living on assistance and in poor, distressed areas all their lives, or we’re going to have to align the support systems to enable and support them to make that transition,” said he declared. said. “People deserve at least an opportunity to make that choice to live differently.”

Economic development tool

The nonprofit Access Health is designed as a bridge for small employers to provide employee health coverage until they can afford the commercial market. About 500 people who work in 220 small businesses in Muskegon County and northern Ottawa County are covered by Access Health, which over the years has worked with more than 2,000 employers.

Access Health reopened to new enrollments in May after winning a waiver for innovative health coverage that temporarily restored $2 million in lost funding. The health plan halted enrollments in 2018 to focus on existing enrollees after losing state and federal Medicaid funding that helped pay the cost of health premiums for employees of participating small businesses.

The loss of funding was a “big blow” to Access Health, which at one point covered more than 1,300 people.

Additionally, Fortenbacher believes Access Health can help “restart local economies” hard hit by the pandemic and allow small employers to better attract and retain employees in an extremely tight labor market because they can afford to provide health services.

“It’s a tool for economic development, especially now that people are saying, ‘I need employees. I need help,’ and they don’t have staff to fill those positions,” he said. “We hear it all the time: Businesses today are facing huge hiring challenges, limiting their ability to maintain regular hours or deliver their pre-COVID service levels. The ability to offer coverage like Access Health can be a game-changer for these small businesses, their employees, and our communities.

Huizinga has previously tried to push legislation forward through Congress to expand the model behind Access Health. A bill he introduced in 2019 failed to make it out of committee.

Fortenbacher doubts that Huizenga’s new legislation can be passed before the end of this session of Congress in January 2023. Bringing the bill back now can lay the groundwork to begin building support this year for another reintroduction and pushing the new mandate of Congress.

Proponents of expanding the Access Health model will also have to convince Affordable Care Act advocates that the Obama-era law and expanding Medicaid are not panaceas for getting people covered.

“We’re just going to have to start doing our networking and get education there to get people to understand,” Fortenbacher said. “It’s ultimately going to have to cross political lines.”

Ryan H. Bowman