Restoring & Sustaining Small Employer Health Insurance Coverage in Post- Pandemic New Jersey Rutgers Center for State Health Policy Policy Forum Series July 16, 2020 Visit us at www.CSHP.Rutgers.edu or on Twitter @RutgersCSHP Rutgers Center for State Health Policy (CSHP) is a unit of the Institute for Health, Healthcare Policy and Aging Research within Rutgers Biomedical and Health Sciences (RBHS)
Housekeeping Items Default: All attendees’ audio lines will be muted upon joining the event. • Enter your question in the Q/A box. • Forum will be recorded. Slides and recording will be posted. • Please complete the online satisfaction survey after this webinar. Center for State Health Policy 2 Institute for Health, Health Care Policy and Aging Research
Acknowledgements • Support for this event was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect those of the Foundation. • We acknowledge our colleagues, Oliver Lontok, Bram Poquette & John Palatucci for their efforts in planning & executing this virtual forum. • We thank our panelists in advance for sharing their expertise and insights and all of you for participating in this discussion. Center for State Health Policy 3 Institute for Health, Health Care Policy and Aging Research
About the Center for State Health Policy • Launched in 1999 with core support from the Robert Wood Johnson Foundation • Translational health policy center with a mission to inform, support and stimulate sound and creative health policy in New Jersey and around the nation • The Center’s research and project portfolio focuses on: – Health System Performance Improvement – Access to Care and Coverage – Population Health – Health and Long-Term Care Workforce – Long-Term Services and Supports Visit us at www.cshp.Rutgers.edu or on Twitter @RutgersCSHP Center for State Health Policy 4 Institute for Health, Health Care Policy and Aging Research
Goal of the Policy Forum Series • Address the most critical health and health care policy issues impacted by the COVID-19 pandemic in New Jersey • Draw on timely and relevant data and expert discussion of policy strategies to address short- and long-term challenges • Topics under consideration for future forums: – COVID- 19’s Impact on Substance Misuse and Treatment – Future of Telehealth – What’s Next for NJ’s HealthCare Workforce? – Mitigating the pandemic’s impact on mental health – Addressing health-related social needs such as food and housing insecurity Center for State Health Policy 5 Institute for Health, Health Care Policy and Aging Research
Agenda • Introductions • Overview of State and National Economic Outlook • Snapshot of NJ’s Small Group Market (SGM) • Policy Option Discussion – Addressing Affordability in SGM – Opportunities/limitations of individual coverage – Tradeoffs of “alternative markets” – Maximizing value of NJ’s State Based Exchanged (SBE) • Q&A • Additional Resources Center for State Health Policy 6 Institute for Health, Health Care Policy and Aging Research
Panelists Linda Schwimmer Carl Van Horn Christine Buteas Peter Newell Wardell Sanders President & CEO of the NJ Distinguished Professor & Chief Government Affairs Director, Health Insurance President, NJ Association HealthCare Quality Institute Director, Rutgers Heldrich Officer, NJ Business and Project, United Hospital Fund of Health Plans Center for Workforce Industry Association Development Margaret Koller Joel C. Cantor Distinguished Professor & Director Executive Director Rutgers Center for State Health Policy Rutgers Center for State Health Policy Center for State Health Policy 7 Institute for Health, Health Care Policy and Aging Research
Snapshot of NJ’s Small Group Market (SGM) • Peak enrollment in standard plans of 981K in 2005 • Average enrollment decline exceeds 10K per quarter since • Elimination of “Mom & Pop” groups of 2 under the ACA • SGM premiums increasing by 38.5% since 2008 • Subsidies available in Individual Market up to 400% FPL • Growth of alternative markets w/ inconsistent oversight – MEWAs – PEOs – Self-Insured/Level-Funded • Q1-2020 enrollment in the Individual Market exceeds the SGM Center for State Health Policy 8 Institute for Health, Health Care Policy and Aging Research
Sources of Health Insurance United States and New Jersey, 2018 100% 7% 9% 90% Uninsured 80% Other 70% Medicare 60% Medicaid 50% Non-Group Employer 40% 30% 57% 49% 20% 10% 0% US New Jersey Source: KFF, Health Insurance Coverage of the Total Center for State Health Policy Population http://www.kff.org/other/state-indicator/total- 9 Institute for Health, Health Care Policy and Aging Research population/
Percent Uninsured - Non-elderly Adults (18-64 years old) United States and New Jersey, 2008-2018 30.0% US New Jersey ACA 20% 20.0% 17% 13% 10.0% 9% 0.0% 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Source: National Center for Health Statistics, Health Interview Survey. Center for State Health Policy http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201905.pd f 10 Institute for Health, Health Care Policy and Aging Research
Small Group Health Insurance Offer Rates Percent of Private Establishments (<50 employees) Offering Coverage, 2009-2018 United States New Jersey New York Pennsylvania 60% 56% 50% 40% 36% 41% 30% 30% 20% 10% 0% 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Source: Medical Expenditure Panel Survey, https://meps.ahrq.gov/mepsweb/ Center for State Health Policy 11 Institute for Health, Health Care Policy and Aging Research
Small Group Single Health Insurance Premiums Private Establishments <50 employees, 2008-2018 United States New Jersey New York Pennsylvania $10,000 $7,610 $8,000 $5,193 $6,000 $6,667 $4,000 $4,501 $2,000 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 $0 Source: Medical Expenditure Panel Survey, https://meps.ahrq.gov/mepsweb/ Center for State Health Policy 12 Institute for Health, Health Care Policy and Aging Research
NJ Individual and Small Group Health Insurance Covered Lives, 2008-2020 Individual Market Small Group Market 850,615 900,000 750,000 647,374 600,000 450,000 316,580 300,000 304,357 150,000 146,095 96,385 0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 Q1 Note: All years Q4, except for 2020 (preliminary Q1) Center for State Health Policy Source: NJ DOBI Enrollment Data 13 Institute for Health, Health Care Policy and Aging Research http://www.state.nj.us/dobi/division_insurance/index.htm
Thank you! Questions? Please return the post forum survey. Visit us at www.cshp.Rutgers.edu or on Twitter @RutgersCSHP Center for State Health Policy 14 Institute for Health, Health Care Policy and Aging Research
Resources ➢ Short and Long-Term Strategies to Support Health Care Affordability and Price Transparency for Small Employers and Consumers in New Jersey NJ Healthcare Quality Institute https://www.njhcqi.org/wp-content/uploads/2020/07/Short-and-Long-Term-Strategies-to-Support-Health-Care- Affordability-and-Price-Transparency-for-Small-Employers-and-Consumers-in-New-Jersey.pdf ➢ NJBIA’s 61st Annual Business Outlook Survey https://njbia.org/wp-content/uploads/2016/05/NJBM-Dec-2020BusinessOutlookSurvey61stAnnual.pdf ➢ NJBIA’s 2018 Health Benefits Survey https://njbia.org/wp-content/uploads/2016/05/2018HealthBenefits.pdf ➢ Can Lessons from the Great Recession Guide Policy Responses to the Pandemic-Driven Economic Crisis? J. Oates and C Van Horn, Federal Reserve Bank of Atlanta https://www.frbatlanta.org/-/media/documents/cweo/workforce-currents/2020/06/16/can-lessons-from-the-great-recession-guide- policy-responses-to-the-pandemic-driven-economic-crisis/can-lessons-from-the-great-recession-guide-policy-responses-to-the- pandemic-driven-economic-crisis.pdf ➢ Assessing the Financial Impact of the Pandemic on New Jersey Businesses and Nonprofits Rutgers John J. Heldrich Center for Workforce Development https://www.heldrich.rutgers.edu/newsroom/assessing-financial-impact-pandemic-new-jersey-businesses-and-nonprofits Center for State Health Policy 15 Institute for Health, Health Care Policy and Aging Research
Resources ➢ Larger Small Groups: Challenges to Bolstering New York’s Small Group Market United Hospital Fund ➢ Larger Small Groups: Implementing the New ACA Small Employer Definition in New York United Hospital Fund ➢ New York’s Small Group Market Isn’t Feeling Well -and a Trump Administration Proposal May Make Things Worse United Hospital Fund https://uhfnyc.org/media/filer_public/9b/6d/9b6d5466-d6b1-4f47-b9db-f6dac948f20a/healthwatch-smgrp-final-20171206_5.pdf Center for State Health Policy 16 Institute for Health, Health Care Policy and Aging Research
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