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Despite What You Might Think, the Affordable Care Act Is Law–Really

Communication will play a key role as enrollment season nears. One study shows that 59 percent of Americans do not know that health care reform is a law and that it's being implemented.

June 13, 2013

Getting employees to understand how health care reform will affect their benefits in time for fall open enrollment is a challenge for most employers, but HR executive Laura Ostroff has had to jump into the fray sooner than most. Benefits enrollment kicks off July 1 at Bon Secours Health System, where she is vice president of benefits and human resources information systems.

"We are waiting with bated breath for more federal guidelines," she says. "But we've had to move forward. We share what we know when we know it."

In addition to unanswered questions about the state health insurance exchanges, the nonprofit Catholic health system headquartered in Marriottsville, Maryland, is also rolling out a brand-new benefits plan that takes effect on Sept. 1.

Like Bon Secours, employers large and small are scrambling to prepare their workforce for the provisions in the Affordable Care Act that take effect in 2014 and beyond. This is no easy task given the complexity of the massive health reform law and the dearth of federal guidelines. And with the ongoing political wrangling from opponents trying to repeal or cripple the law, it's no surprise that most Americans are confused about the impact reform will have on their lives. More than half don't even know that the Affordable Care Act is in place.

According to an April Kaiser Family Foundation poll, 59 percent of Americans do not know that health care reform is law and is being implemented, while nearly half—49 percent—say they don't have enough information to know how the law will affect their family.

"Lots of employers are communicating early this enrollment season, like July and August, before people get inundated with information," says Michelle Hicks, communications director at Buck Consultants in New York. She says that insurers competing on the exchanges are expected to flood consumers with direct mailings and television ads promoting their products.

Under the individual mandate, all Americans will be required to purchase health insurance or face a fine. Those who aren't covered through an employer will be able to buy insurance on a state health insurance marketplace or exchange, which must be up and running by Jan. 1.

"For those unaware of the ACA, getting a mailer saying you have to get health care insurance or be fined will set off a panic, and employers need to be prepared," says Hicks.

In addition, the U.S. Department of Health and Human Services is hitting the airwaves and the Web this summer, rolling out an $8 million campaign to educate people about the exchanges and encourage them to shop for health care insurance. Other HHS initiatives include a relaunch of Healthcare.gov as the information hub for those shopping for insurance and outreach to Spanish-speaking communities and other non-native speakers.

Employers also are targeting their communications to different employee populations.

"Some employers have a significant population of part-time employees who will not be eligible for the employer plan," Hicks says. "And there is a handful who wants to make sure that even if they don't provide health insurance, their employees understand how the exchanges work. And then there is a third pocket—the newly eligible. Anyone who works 30 hours a week or more will be eligible for the employer plan. Some have never had benefits before."

At Bon Secours, Ostroff isn't worried about employees understanding or supporting the health care reform law.

"We are a Catholic health system, and our mandate is to help the poor, so we are a strong proponent of the ACA," Ostroff says. "It fits with our culture and that makes it easier for us to communicate. Our employees get it. They see the uninsured coming in with serious health conditions every day."

Still, she says that this year benefits communications are splashier and more detailed than previous years because of changes brought by reform. In an effort to avoid penalties under the law's so-called "Cadillac" tax on expensive health plans, Bon Secours is replacing its gold, silver and bronze benefits packages with a preferred provider organization, a high-deductible plan and a catastrophic coverage plan for 2014. The tax goes into effect in 2018.

"This year the communication plan had to be more thoughtful, more creative and more engaging than before," she says.

Rita Pyrillis is Workforce's senior writer. Comment below or email editors@workforce.com. Follow Pyrillis on Twitter at @RitaPyrillis.