J.eff Fortenbacher believes Access to Health is ready for the national scene and to help America ‘s smallest small businesses afford employee health coverage.
If Congress passes funding legislation to prove it, Fortenbacher sees Access Health as a national model to replicate in communities across America, offering affordable coverage that is accessible to both employers and their employees.
Jeff Fortenbacher, Bill Heisenga
“It’s a solution,” said Fortenbacher, CEO of Access Health, which for more than 20 years has provided basic, low-cost coverage to small businesses that previously could not afford it and hire people who they are usually low paid.
“I know it will work,” he said. “We’ve demonstrated that it works.”
Access Health uses cheap bonuses paid by both employers and employees, plus federal Medicaid funding that goes through the state to support coverage that is typically purchased by small businesses in low-wage sectors.
Small employers enrolled in Access Health currently pay $ 70 a month per employee for basic coverage, which comes with low co-payments and zero deductions, which are often barriers for low-income people to afford health insurance. Employees pay the same monthly premium, and another $ 70 comes from federal funding from Medicaid, which goes to care providers.
However, Access Health coverage is limited and good only for local care providers in Muskegon County and northern Ottawa County.
U.S. Representative Bill Huizenga, R-Zeeland, plans to reintroduce federal legislation that will require the U.S. Department of Health and Human Services to fund three to four pilot programs nationwide to test the model behind Access Health, and to expand the program in Western Michigan.
“This is an innovative way to deal with a real problem,” Huyzenga told a recent news conference at the Access Health office in Muskegon. “We know it will save money, but it will also – perhaps more importantly – provide care.”
Fortenbacher cites actuarial data showing that the health plan provides coverage that is 55% lower than health coverage purchased on a stock exchange that complies with federal Affordable Care Act.
The key to this outcome is an intensive focus on well-being and health prevention, the management of costly chronic medical conditions and comprehensive services that seek to address the social determinants of an individual’s health, such as financial status, home life or work.
Fortenbacher sees the model not simply as a way to provide basic coverage that allows people to have access to care when needed, but as providing a “transitional way out of poverty” and leading people to economic independence.
“Either we will have a bunch of people living in aid and in poverty and needy areas all their lives, or we will have to align support systems to allow them and support them to make this transition,” he said. . “People deserve at least the opportunity to make that choice to live differently.”
An instrument for economic development
The non-profit organization Access Health is designed as a bridge that allows small employers to provide health coverage to employees while they can afford the commercial market. About 500 people working in 220 small businesses in Muskegon County and northern Ottawa County are covered by Access Health, which has worked with more than 2,000 employers over the years.
Access Health reopened for new enrollments in May after securing a waiver of innovative health coverage that temporarily reimbursed $ 2 million in lost funding. The Health Plan stopped enrollment in 2018 to focus on existing enrollment after losing state and federal funding from Medicaid, which helped pay for health premiums for employees in participating small businesses.
The loss of funding was a “huge blow” to Access Health, which at one point affected more than 1,300 people.
In addition, Fortenbacher believes that Access Health can help “restart local economies” affected by the pandemic and enable small employers to better attract and retain employees in a tight labor market because they can allow them to offer health benefits.
“It’s a tool for economic development, especially now that people are saying, ‘I need employees. “I need help, and they don’t have people to take those positions,” he said. “We hear it all the time: businesses today face enormous employment challenges that limit their ability to meet regular working hours or provide pre-COVID service levels. Offering coverage like Access Health can change the game for these small businesses, their workers and our communities.
Huizinga has previously sought to improve legislation through Congress to expand the model behind Access Health. The bill he introduced in 2019 failed to leave the committee.
Fortenbacher doubts that Huyzenga’s new legislation could change before the end of the current session of Congress in January 2023. The return of the bill can now lay the groundwork for building support this year for a new reintroduction and new mandate. of Congress.
Proponents of expanding the Access Health model will also need to convince proponents of the Affordable Care Act that the Obama-era law and the Medicaid expansion are not easy to cover.
“We just have to start networking and get it education there to make people understand, ”Fortenbacher said. “Eventually he will have to cross political lines.”