Much attention has been paid lately to the role of small businesses in advancing health insurance coverage, right down to last Tuesday’s choice to release the new Health Insurance Exchange Regulation at a local DC hardware store. Such small businesses employ over 42 million Americans, yet because of their small scale and the escalating costs of health insurance coverage, many struggle to purchase or maintain coverage for their employees. As a result, nearly 23 million small business owners, employees, and dependents are uninsured.
New opportunities offered by the ACA, including the Small Business Health Care Tax Credit, better position these employers to offer coverage. States must strategize about how they may wish to engage small businesses in the health insurance market to take advantage of these opportunities. To glean some important outreach lessons for states, I recently spoke with Terry Gardiner, Vice President of Policy and Strategy, and Jessica Stone, Outreach Manager, of the Small Business Majority, who shared the following valuable lessons:
1) Small businesses are not your typical consumer
Small business owners are busy individuals whose primary interest is to ensure that their businesses stay afloat. Messages tailored to small businesses need to be clear, concise, and should focus on how health insurance might improve a business’s bottom line. Outreach workers should prepare an elevator speech that can quickly engage employers by mentioning such positive benefits like the Health Care Tax Credit. These workers should also be prepared to offer support options for employers who lack administrative personnel to assist in the procurement and administration of health insurance.
2) There is not one “silver bullet” approach to reaching small businesses
The U.S.’s 5.8 million small businesses range greatly in everything from industry (agriculture, retail, construction, etc) to location (rural, urban, suburban). Owners may spend most of their time at a desk, out in the field, or even working out of their car, while employees may be full-time, part-time, seasonal or salaried. States should closely examine their small employer industries and develop multiple outreach strategies that account for this variability through creativity and targeted messaging.
3) Network! Network! Network!
Only about half of small businesses belong to a formal business group such as a chamber of commerce. So in addition to reaching out to those groups, states should look for local networks like community groups (e.g. Kiwanis Club) and trade associations (e.g. local alliance of realtors) through which outreach can be presented on a business owner’s “home turf.” States may also research licensing databases for lists of licensed businesses by size and region. Outreach efforts will work best when they strive to engage small business owners through a clear presentation of facts on access to health care and insurance opportunities relevant to the local community.
4) Promote small businesses as “catalysts for change”
Increased participation and pooling of small employers in the health insurance market, especially with the development of the Small Business Health Options Program (SHOP Exchanges), will likely increase their influence over market behavior and practices. States can work with small businesses to capitalize on this influence and promote innovative insurance design including health co-ops, integrated health plans, and plans with wellness programs. This increased empowerment can also be leveraged as a selling point in messaging to small businesses, especially for those that have previously been reluctant to buy health insurance coverage.
Examples of approaches and materials developed with such valuable lessons in mind are available from several SHAP states including Maine, New York, Texas, and Washington, which have all strategized on ways to educate small employers about health insurance coverage opportunities. Many thanks to Mr. Gardiner and Ms. Stone for sharing their insights on this topic. As always, if you would like any additional technical assistance on this or any other topic, please feel free to contact our SHAP team: Anne Gauthier, Kathy Witgert, Denise Osborn, Chris Cantrell, or Christina Miller.