Jeff Fortenbacher believes Access Health is ready for the national stage and to help the smallest of U.S. small businesses afford employee health coverage.
If Congress were to enact legislation providing funding to prove it, Fortenbacher sees Access Health as a national model to replicate in communities across America by offering affordable coverage that’s within reach for both employers and their employees.
“It’s one solution,” said Fortenbacher, the CEO of Access Health, which for more than 20 years has provided basic, low-cost coverage to small businesses that previously were unable to afford it and employ people who are generally low-wage earners.
“I know it will work,” he said. “We’ve demonstrated it works.”
Access Health uses low-cost premiums paid by both employers and employees, plus federal Medicaid funding that’s funneled through the state, to support coverage that’s typically been bought by small businesses in low-wage sectors.
Small employers enrolled in Access Health presently pay $70 a month per employee for basic coverage that comes with low copays and zero deductibles that are often barriers to low-income people affording health insurance. Employees pay the same monthly premium, and another $70 comes from federal Medicaid funding that goes to care providers.
However, Access Health coverage is limited and only good at local care providers in Muskegon County and northern Ottawa County.
U.S. Rep. Bill Huizenga, R-Zeeland, plans to reintroduce federal legislation soon that would require the U.S. 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 the program in West Michigan.
“This is an innovative way of getting at a real problem,” Huizenga said during a recent news conference at the Access Health office in Muskegon. “We know that it’s going to save money, but it also — maybe more importantly — is going to deliver care.”
Fortenbacher points to actuarial data showing the health plan provides coverage at costs that are 55-percent less than health coverage purchased on an exchange that complies with the federal Affordable Care Act.
Key to that outcome is an intense focus on wellness and health prevention, managing costly chronic medical conditions, and wrap-around services that look to address an individual’s social determinants of health, such as their financial status, home life or connecting them with work.
Fortenbacher views the model as not just a way to provide basic coverage that enables people to access care when needed, but as providing a “transitional path out of poverty” and leading people to economic independence.
“We’re either going to have a whole bunch of people living on assistance and in poverty and distressed areas their whole life, or we’re going to have to align support systems to allow them and support them to make that transition,” he said. “People deserve at least an opportunity to make that choice to live differently.”
Economic development tool
The nonprofit Access Health is designed as a bridge to enable small employers to provide employee health coverage until they can afford the commercial market. About 500 people who work at 220 small businesses in Muskegon County and northern Ottawa County are covered by Access Health, which over the years has worked with more than 2,000 employers.
Access Health reopened to new enrollments in May after securing a waiver for innovative health coverage that temporarily restored $2 million in lost funding. The health plan halted enrollments in 2018 to focus on existing enrollees after losing state and federal Medicaid funding that helped to pay the cost of health premiums for employees at participating small businesses.
Losing the funding was a “huge hit” to Access Health, which at one point covered more than 1,300 people.
As well, Fortenbacher believes Access Health can help “reboot local economies” hit hard by the pandemic and enable small employers to better attract and keep employees in a fiercely tight labor market because they can afford to offer health benefits.
“It’s an economic development tool, especially now when people are saying, ‘I need employees. I need help,’ and they don’t have people to fill those positions,” he said. “We hear it all the time: Businesses today face massive hiring challenges, which limit their ability to keep regular hours or provide their pre‐COVID service levels. The ability to offer coverage like Access Health can be a game-changer for these small businesses, their workers and our communities.”
Huizinga has previously tried to advance legislation through Congress to expand the model behind Access Health. A bill he introduced in 2019 failed to move out of committee.
Fortenbacher doubts Huizenga’s new legislation can move before the present congressional session ends in January 2023. Bringing back the bill now can set the foundation to begin building support this year for another reintroduction and push in the new congressional term.
Advocates for expanding Access Health’s model also will have to convince defenders of the Affordable Care Act that the Obama-era law and Medicaid expansion are not the cure-alls for getting people covered.
“We’re just going to have to start to do our networking and get the education out there to get people to understand,” Fortenbacher said. “It’s ultimately going to have to go across political lines.”