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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

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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)

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Center for State Health Policy

Institute for Health, Health Care Policy and Aging Research

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.

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Center for State Health Policy

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.

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Center for State Health Policy

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

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Center for State Health Policy

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

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Center for State Health Policy

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

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Center for State Health Policy

Institute for Health, Health Care Policy and Aging Research

Panelists

Christine Buteas Chief Government Affairs Officer, NJ Business and Industry Association

Wardell Sanders President, NJ Association

f Health Plans

Linda Schwimmer President & CEO of the NJ HealthCare Quality Institute Carl Van Horn Distinguished Professor & Director, Rutgers Heldrich Center for Workforce Development Peter Newell Director, Health Insurance Project, United Hospital Fund Joel C. Cantor Distinguished Professor & Director Rutgers Center for State Health Policy Margaret Koller Executive Director Rutgers Center for State Health Policy

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Center for State Health Policy

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

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Center for State Health Policy

Institute for Health, Health Care Policy and Aging Research

Sources of Health Insurance

United States and New Jersey, 2018

49% 57% 9% 7%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

US New Jersey

Uninsured Other Medicare Medicaid Non-Group Employer

Source: KFF, Health Insurance Coverage of the Total Population http://www.kff.org/other/state-indicator/total- population/

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Center for State Health Policy

Institute for Health, Health Care Policy and Aging Research

Percent Uninsured - Non-elderly Adults (18-64 years old)

United States and New Jersey, 2008-2018

20% 13% 17% 9% 0.0% 10.0% 20.0% 30.0% 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

US New Jersey

Source: National Center for Health Statistics, Health Interview Survey. http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201905.pdf

ACA

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Center for State Health Policy

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

Source: Medical Expenditure Panel Survey, https://meps.ahrq.gov/mepsweb/

41% 30% 56% 36% 0% 10% 20% 30% 40% 50% 60%

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

United States New Jersey New York Pennsylvania

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Center for State Health Policy

Institute for Health, Health Care Policy and Aging Research

Small Group Single Health Insurance Premiums

Private Establishments <50 employees, 2008-2018

$4,501 $6,667 $5,193 $7,610 $0 $2,000 $4,000 $6,000 $8,000 $10,000

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

United States New Jersey New York Pennsylvania

Source: Medical Expenditure Panel Survey, https://meps.ahrq.gov/mepsweb/

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Center for State Health Policy

Institute for Health, Health Care Policy and Aging Research

96,385 146,095 316,580 850,615 647,374 304,357 150,000 300,000 450,000 600,000 750,000 900,000 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Individual Market Small Group Market

Note: All years Q4, except for 2020 (preliminary Q1) Source: NJ DOBI Enrollment Data http://www.state.nj.us/dobi/division_insurance/index.htm

NJ Individual and Small Group Health Insurance

Covered Lives, 2008-2020

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Center for State Health Policy

Institute for Health, Health Care Policy and Aging Research

Thank you! Questions?

Please return the post forum survey.

Visit us at www.cshp.Rutgers.edu or on Twitter @RutgersCSHP

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Center for State Health Policy

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

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Center for State Health Policy

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