How will the outcome of King v. Burwell, the current case before the Supreme Court challenging the Affordable Care Act, impact your key stakeholders?
If you're not sure, you're not alone. According to a recently released study by RAND Corporation, less than six percent of U.S. adults are aware of King v. Burwell and are not able to correctly identify what potential effect the decision could have.
The central question in this case is whether or not tax credits and cost-sharing subsidies can be legally provided to the more than 6.4 million individuals who have purchased health insurance in states that did not establish their own state-based insurance marketplace, but rather participate in federally-facilitated marketplaces.
According to the Kaiser Family Foundation, consumers who purchased health insurance in a federal-facilitated marketplace state only pay on average 28% of their premium, because of the current subsidies. With the subsidies eliminated, these individuals could face an average increase in their out-of-pocket costs for insurance of more than 250%, potentially making the insurance unaffordable.
No matter what the Supreme Court decides, news coverage of the outcome will raise questions among patients, employees, board members and other stakeholders. Here are the five things you should be doing now to prepare:
1. Know whether your organization is in a FFM or SBM state.
This may sound basic, but you should make sure that you know which states operate a state-based marketplace (SBM) or federally-facilitated marketplace (FFM).
With geographical boundaries between states increasingly blurred for patient care, you need to know where your patients and employees live, and whether they could be affected. Be sure to have a strategy that clearly outlines the impact for each of the states that your patients and employees live in.
The most up-to-date list of conditionally approved state-based marketplace states by CMS can be found here.
2. Develop communications materials including stand-by statements.
The one thing that is certain is that Supreme Court (SCOTUS) rulings are not easy to predict and can be complicated. In fact, when the SCOTUS ruled on the ACA's individual mandate in 2012, several cable news outlets got the ruling wrong in the first few minutes. You should be prepared with an immediate stand-by statement that lets your audiences know that you are conducting proper analysis and gives your community confidence that you are watching out for them.
You also want to make sure that you've engaged with the appropriate legal counsel to review your stand-by communications in advance. Counsel should also be available on decision day to provide real-time input and feedback.
In the event of a ruling that limits availability of subsidies, many believe that Congress and the White House will work out a deal to fix the law. State governors and legislatures could also have a role in defining the future for each state. However, it may weeks for those plans to be finalized. Developing draft statements in advance will allow you to have an important internal discussion about what you will say publically in the event that there is a ruling that impacts your state. Will you publically call on Congress to act to address this? Will you call on your governor or state legislature to take action?
The most important thing to remember in developing these statements is to reassure your patients and employees that you are there for them and will assist in ensuring there is continuity of care.
3. Know where to get the right information.
SCOTUS Blog is a reliable source of information for news coming out of the Court. This private organization "live blogs" each day that the Court issues rulings – and you can sign up to receive and email reminder when the court comes in to session. In addition, be sure to check with your state's insurance department, governor's office and the Centers for Medicare and Medicaid Services (CMS).
Local insurance carriers and the health insurance trade associations will also be tracking this issue closely and will likely publish information as soon as their analyses are complete. You can check out America's Health Insurance Plans (AHIP) or the Blue Cross and Blue Shield Association on decision day as well.
4. Communicate clearly about who is NOT impacted.
Don't forget to communicate clearly about who is NOT impacted. Individuals and families with employer-sponsored insurance or Medicare or Medicaid will not be impacted by this decision, so don't forget to include this in your communications. There has been a lot of confusion about the impact of the ACA on seniors especially, so this is a good opportunity to engage with those communities and make sure they have the right information.
5. Develop a Communications Plan and Cascade.
As you prepare for any evolving communications issue, you should develop a communications plan with key stakeholders clearly identified (e.g., employees, patients, media, board of directors, reception and receiving staff), the message you will communicate to each audience, the channel (e.g., email, newsletter, poster, phone call) and who is responsible for disseminating the message to each group.
Susannah Buckley-Green is a Director at Burson-Marsteller focusing on helping companies understand the changing insurance landscape and communicate effectively to both internal and external stakeholders.
The views, opinions and positions expressed within these guest posts are those of the author alone and do not represent those of Becker's Hospital Review/Becker's Healthcare. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them.