yF. Fortenbacher . believed Access to health Ready for the national stage and to help the smallest of small businesses in the United States afford employee health coverage.
If Congress enacts legislation providing funding to prove it, Fortenbacher sees Access Health as a national model to replicate in communities across America by offering affordable coverage within the reach of both employers and their employees.
Jeff Fortenbacher, Bill Huizinga
“It’s one solution,” said Fortenbacher, CEO of Access Health, which for more than 20 years has provided basic, low-cost coverage to small businesses that previously couldn’t afford it and generally hire low-paying people.
“I know it will work,” he said. “We’ve shown that it works.”
Access Health uses low-cost premiums paid by both employers and employees, as well as federal Medicaid funding channeled across the state, to subsidize coverage typically purchased by small businesses in lower-wage sectors.
Small employers registered with Access Health currently pay $70 a month per employee for basic coverage that comes with low co-pays and a zero deductible that are often barriers to low-income people who provide health insurance. employees Pay the same monthly premium, and another $70 comes from federal Medicaid funding that goes to caregivers.
However, Access Health’s coverage is limited and only good at local providers in Muskegon County and northern Ottawa County.
US Representative Bill Huizinga, Republic of Zeeland, plans to soon reintroduce federal legislation 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 expand a program in western Michigan.
“This is an innovative way to solve a real problem,” Huizenga said during a recent press conference in the Office of Access Health in Muskegon. “We know it will save money, but it will also – perhaps most importantly – save care.”
Fortenbacher points to actuarial data showing that a health plan provides coverage at 55 percent lower costs than health coverage purchased on an exchange compliant with the Federal Affordable Care Act.
Key to this finding is an intense focus on wellness and health prevention, management of costly chronic medical conditions, and comprehensive services that look to address an individual’s social determinants of health, such as financial status or home life or their connection to work.
Fortenbacher views the model as not just a way to provide basic coverage that enables people to get care when needed, but as providing a “transitional path out of poverty” and leading people to economic independence.
“Either we will have a whole group of people who live on assistance and live in poverty and stricken areas their whole lives, or we will have to align support systems to allow and support them to make that transition,” he said. “People deserve at least a chance to make that choice to live differently.”
economic development tool
The nonprofit Access Health is designed as a bridge to enabling small employers to provide health coverage to employees so that they can afford the commercial market. Access Health covers approximately 500 people who work for 220 small businesses in Muskegon County and Northern Ottawa County, which over the years have worked with more than 2,000 employers.
Access Health reopened to new enrollments in May after obtaining a waiver for Innovative Health Coverage that temporarily restored $2 million in lost funding. The health plan suspended enrollment in 2018 to focus on existing enrollees after losing state and federal Medicaid funding that helped pay for health insurance premiums for employees at participating small businesses.
The loss of funding was a “huge blow” for Access Health, which at one point covered more than 1,300 people.
Additionally, Fortenbacher believes Access Health can help “reboot local economies” hard hit by the pandemic and enable small employers to attract and keep employees in a tight labor market because they can afford to provide health benefits.
“It’s a tool for economic development, especially now when people say, ‘I need employees. I need help, “and they have no one to fill these jobs,” he said. “We hear it all the time: Businesses today face enormous employment challenges, limiting their ability to maintain normal business hours or provide pre-COVID levels of service. The ability to offer coverage like Access Health could be a game changer for these small businesses, their workers, and our communities. “.
Huizinga previously attempted to advance legislation through Congress to expand the model behind Access Health. A bill he introduced in 2019 failed to get out of committee.
Fortenbacher doubts the new Huizenga legislation can move before the current congressional session ends in January 2023. Bringing the bill back could now lay the groundwork to begin building support this year to reintroduce it again and push the new Congress mandate.
Advocates of expanding the Access Health model will also have to convince advocates of the Affordable Care Act that the Obama-era law and Medicaid expansion are not the right treatment to cover people.
“We just have to start doing our networking and getting Education is there to make people understand, Fortenbacher said. “Eventually he will have to cross political lines.”