Senate panel to begin bipartisan hearings on stabilizing health insurance market

WASHINGTON – Senators looking for ways to stabilize the individual health insurance market will hear from governors and state health insurance commissioners at their first bipartisan hearings next month.

The hearings, set for Sept. 6-7, will focus on stabilizing premiums and helping people in the individual market in light of Congress’ failure to repeal and replace the Affordable Care Act, or Obamacare.

“Eighteen million Americans, including 350,000 Tennesseans – songwriters, farmers, and the self-employed – do not get their health insurance from the government or on the job, which means they must buy insurance in the individual market,” said Sen. Lamar Alexander, the Tennessee Republican who chairs the Senate Health, Education, Labor and Pensions Committee.

“My goal by the end of September is to give them peace of mind that they will be able to buy insurance at a reasonable price for the year 2018,” Alexander said.

Sen. Patty Murray, D-Wash.

(Photo: H. Darr Beiser, USA TODAY)

Washington Sen. Patty Murray, the committee’s top Democrat, said the path to making health care work better for patients and families “isn’t through partisanship or backroom deals.”

“It is through working across the aisle, transparency, and coming together to find common ground where we can,” she said.

The attempts at a bipartisan approach to fixing health care mark a change in strategy after the failure last month of Republican efforts to repeal and replace Obamacare. The GOP bill was pieced together behind closed doors by a small group of Republican senators, with no input from Democrats and no public hearings.

Alexander has said lawmakers must find a way to stabilize the individual insurance market because millions of Americans will be unable to buy insurance unless Congress acts.

At the hearings, the committee will hear from state insurance commissioners and governors because they are closest to the problem and can suggest steps that Congress can take to help make insurance available at affordable prices, Alexander said.

“Any solution that Congress passes for a 2018 stabilization package will have to be small, bipartisan and balanced,” he said.

It also should give states more flexibility in approving insurance policies and fund the cost-sharing reduction payments to help stabilize premiums for 2018, he said.

Murray said it’s important for the committee to hear from state leaders because they “understand full well the challenges facing health care today, and many have been outspoken about how the uncertainty caused by this administration has impacted the individual insurance market and therefore families’ premiums for 2018.”

, USA TODAYPublished 11:29 a.m. ET Aug. 22, 2017


Simplifying the healthcare payment system

With employers and employees expected to carry a rapidly increasing portion of out-of-pocket healthcare spend, enterprises and employees alike are in need of new tools that reduce the complexities of healthcare billing, help navigate rising cost and make more educated plan and benefit choices.

To help their clients in this endeavor, brokers may want to take a look at a new product that attempts to simplify the healthcare payment and saving system. By utilizing a collaboration of healthcare, benefits and financial networks, Medxoom has initiated the first wave of its app to deliver mobile-first bill payment and financing for users.

Tito Milla, co-founder of Medxoom, says the app is meant to give price awareness to employees who might not know that their health plan, doctor’s office or their prescriptions are not the cheapest choice within the options provided to them.

Bloomberg/file photo

“When you look at the market today, the growth of out-of-pocket spending has grown to over 250% since 2006,” Milla says. “The average is well above $1,000 across the country and for employers with under 200 employees, the number jumps to $2,000.”

Milla adds that when it comes to billing systems for provider networks, traditionally their payout comes from insurance companies with a 95% to 96% success rate. However, for patient responsibility 30% to 50% of network billing comes from the employee, rather than the insurance carrier, depending on the practice.

“The more the cost shifts to the patient, the more it becomes a billing issue for the doctors,” Milla says. “We are a mobile first platform and we are about making healthcare payments simple.”

With the freedom to not be tied down to one specific doctor and their electronic or paper format of payment, Medxoom provides users with the ability to make payments to any provider with any type of health plan, including PPOs, HMOs and HDHPs — with access to HSAs should the employee have one available.

Jordan Hackmeier, managing partner at Jeff D. Hackmeier & Associates INC. out of Miami, is one of the brokers who has partnered with Milla and the Medxoom team to share the app with his clients. Hackmeier says his firm is piloting the app with a small physicians group and plans to pilot the app with a second client with a 50 to 90 employee base.

“The employers are finding value in this product by the way it provides clarity by explaining what their deductible is, what’s left to be paid, why the employee is still paying out-of-pocket. What is most exciting is how they can still add on more and more features,” Hackmeier says. “It appears to me that this product is going to be something that is going to solve a lot of problems in the healthcare industry.”

One feature Hackmeier says is appealing to him is Medxoom’s ability to offer a loan option to users who lack the funds to pay their medical bills immediately. “If you can’t pay $5,000 to satisfy your deductible at your hospital, Medxoom partners with lenders who will loan you the money,” Hackmeier says.

Comprehensive option
Hunt Turner, co-managing director of Wood Gutmann & Bogart Insurance Brokers out of Tustin, Calif., is sharing Medxoom’s app with his clients on the West Coast, and says Medxoom is one of the more comprehensive options for healthcare apps on the market.

“I’ve seen platforms that are more transparency-driven through analytics, but not really tied specifically to HSAs,” Turner says. “My self-funded clients want to have the best information on the healthcare market and it has been a bit of a challenge to find a good comprehensive site.”

From both Hackmeier and Turner’s clients who are piloting the app at their companies, response has been mostly positive. “I think there is a learning curve just around understanding of what it does and doesn’t do because it is relatively new to consumers,” Turner says. “Those who immediately understand the technology are appreciative of the quick access to information.”

Milla says he and his partners are starting Medxoom in the smaller employer market and want to eventually ramp to the large employer market by the end of 2017, with the assistance of large regional brokers.

White House: Health-Insurer Payments Will Be Made in August

Move comes after Trump warned of halting monthly subsidies


The Trump administration said on Wednesday the federal government would make a set of payments to insurers for August, despite threats from the president that the funding would be halted following the failure of Senate Republicans to repeal most of the Affordable Care Act.

Governors and Democratic lawmakers have been urging President Donald Trump to continue the payments, known as cost-sharing reduction payments, because insurers have said they may pull out of the ACA’s insurance markets or raise premiums in 2018without the funding.

The nonpartisan Congressional Budget Office said in a report Tuesday that premiums for popular, midprice plans on the ACA exchanges would rise 20% next year without the payments.

The money compensates insurers for reducing out-of-pocket costs for some low-income consumers who sign up for plans on the exchanges. About seven million people qualified for the subsidies in 2017.

Some GOP lawmakers oppose the payments, saying the money was never appropriated by Congress and amounts to a bailout for insurers. Recent comments from Mr. Trump had led to questions about whether the next payment, expected around Aug. 22, would be made by the federal government.

“If a new HealthCare Bill is not approved quickly, BAILOUTS for Insurance Companies and BAILOUTS for Members of Congress will end very soon!” Mr. Trump tweeted on July 29 after Senate GOP lawmakers failed to pass a bill to repeal most of the ACA.

The future of the payments remains in question, spurring bipartisan efforts among some in Congress to ensure the funding is preserved.

Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.) are planning hearings on legislation to shore up the ACA markets. The legislation would likely continue the payments in 2018 while giving states greater flexibility on ACA implementation, a change that Republicans have sought.

“Congress owes struggling Americans who buy their insurance in the individual market a breakthrough in the health care stalemate,” Mr. Alexander said in a statement Wednesday after a White House spokesman said the insurer payments would be made in August.

Some Republicans panned the decision on payments and called again for the 2010 health law to be repealed.

“We cannot dig our hands into a hole $20 trillion deep to bail out insurance companies,” Rep. Mark Walker of North Carolina said Wednesday.

Write to Stephanie Armour at and Louise Radnofsky at

Appeared in the August 17, 2017, print edition as ‘Insurers to Receive Payments in August.’

Health Exchange Premiums Would Rise 20% in 2018 If Subsidies Ended, CBO Estimates

Deficit would increase by $194 billion through 2026 if subsidies halted because government would pay more in tax credits

A CBO report released Tuesday estimated that health law exchange premiums would rise 20% in 2018 if subsidies to insurers ended.
A CBO report released Tuesday estimated that health law exchange premiums would rise 20% in 2018 if subsidies to insurers ended.PHOTO: ASSOCIATED PRESS

Premiums for many insurance plans on the Affordable Care Act’s individual market would climb by 20% next year if the Trump administration halts billions of dollars in payments that go to insurers under the health law, the Congressional Budget Office estimated Tuesday.

The payments that help compensate insurers for reducing out-of-pocket costs have become the latest front in the battle over the health law, with President Donald Trump warning he could end the funding after Senate Republicans failed late last month to repeal the ACA.

Democrats, insurers and some governors have been urging Mr. Trump to preserve the payments in order to protect the stability of the individual insurance markets.

The report by the nonpartisan CBO and the Joint Committee on Taxation, a panel that includes House and Senate members, says the ACA markets wouldn’t implode without the funding, estimated at $7 billion this year. But it concludes that a decision by Mr. Trump to halt the payments would raise premiums for mid-priced plans and leave slightly more people without an insurer to choose from on the individual markets.

In an ironic twist, stopping the subsidies would also wind up costing the federal government more in the end, the report said. Higher premiums for mid-priced plans would require the government to pay larger tax credits to consumers to help offset coverage costs. The federal deficit would increase by $194 billion through 2026, the report said.

The assessment reflects the negotiating struggles still ahead over the ACA in Congress, where Republicans have already spent months on failed attempts to repeal and refashion former President Barack Obama’s 2010 health law. The demise of the repeal effort means the ACA will remain in place for the foreseeable future, but its markets remain fragile, with insurers promising to raise premiums or stop participating without the federal money, known as cost-sharing payments.

Now, Republicans must decide whether to work with Democrats to stabilize a law they have pledged for more than seven years to dismantle.

Already, some GOP senators are working with Democrats on a possible bill to preserve the payments to insurers. But some House Republicans opposed to the assistance, which they call a bailout for insurers, are digging in with another push for repeal.

The CBO and tax-panel report also highlights the power the Trump administration now holds over the law. Questions are mounting about whether the federal government will devote resources to the fall open-enrollment period for ACA insurance plans. And Mr. Trump has sounded intent on halting the payments, despite calls from some within his own party who fear a political backlash in the midterm elections if the premium costs rise.

“Regardless of what this flawed report says, Obamacare will continue to fail, with or without a federal bailout,’’ Ninio Fetalvo, a White House spokesman, said in a statement. He added: “No final decisions have been made about the CSR payments. We continue to evaluate the issues.”

Rep. Tom Reed (R., N.Y.,) co-chairman of a bipartisan House group that has advocated for authorizing the cost-sharing payments, called Tuesday’s CBO report “another log on the pile of pressure” on Congress to act. He said the adverse effects that CBO highlighted would disproportionately hit rural counties in GOP-held districts. “Politically and substantively, I just don’t understand how you could stand in front of a town hall and say, ‘I’m sorry I didn’t do anything, because ideologically I wanted to go a different route,’ ” he said.

Democrats seized on the report to assert that Republicans and the Trump administration were threatening to sabotage health insurance.

Sen. Brian Schatz (D., Hawaii) wrote on Twitter on Tuesday afternoon that “the president of the United States is causing health care premiums to go up because he’s mad. Let that sink in.”

The CBO report said that rising premiums would mean that more people would qualify for cost-sharing subsidies. Also, the larger premium tax credits would make buying coverage on the individual market more attractive: While the number of people uninsured would be about 1 million higher in 2018 than in an earlier estimate, it would then be 1 million lower in each year starting in 2020, the CBO estimated.

Premiums for the mid-priced plans on the exchange would be 25% higher by 2020, the CBO projected.

Sens. Lamar Alexander (R., Tenn.) and Patty Murray (D., Wash.) are planning hearings on legislation to shore up the ACA markets following failed GOP efforts to replace most of the health law. The legislation would likely continue the payments in 2018 while giving states greater flexibility in how to implement the ACA, a change that Republicans have sought.

The federal payments compensate insurers for reducing out-of-pocket costs for some low-income consumers who sign up for plans on the exchanges. About seven million people qualified for the subsidies in 2017.

Mr. Trump could choose to end the payments on his own. The cost-sharing subsidies also face a legal threat. House Republicans sought in a 2014 lawsuit to block the payments. A federal district judge in May 2016 ruled that the payments were improper. The Obama administration appealed, and payments to insurers have continued in the meantime.

In another sign the Trump administration may pare back parts of the health law, the Centers for Medicare and Medicaid Services has proposed canceling two Obama administration programs aimed at attaching a fixed price to medical services rather than allowing providers to bill for each individual service.

The payment model, known as bundled payments, were a pilot program under the ACA aimed at reducing medical spending by emphasizing results of care rather than volume.

CMS published a rule last week indicating it planned to cancel bundled payments for heart attacks and bypass surgeries along with an expansion of a joint-replacement payment program that would have included hip surgeries. Both payment programs were scheduled to take effect on Jan. 1.

Separately, the ACA’s markets are on increasingly stronger footing. Centene will offer health coverage on the ACA exchange in 2018 to all Nevada counties, Gov. Brian Sandoval said on Tuesday. The state had been facing the prospect of 14 bare counties.

The announcement means only two counties in the U.S. are at risk of having no insurers participating next year, according to the Kaiser Family Foundation. That’s a sharp drop from more than 40 counties that risked having no participating insurers on the exchanges a few months ago.

Write to Stephanie Armour at

Appeared in the August 16, 2017, print edition as ‘CBO Sees a Jump In Health Premiums.’

Updated Aug. 15, 2017 8:37 p.m. ET

Wall Street Journal –

A Short-Term ObamaCare Fix

An HHS rule change could revive part of the individual market.

Sen. Ron Johnson on Capitol Hill, Aug. 1.
Sen. Ron Johnson on Capitol Hill, Aug. 1. PHOTO: ASSOCIATED PRESS

Republicans in Congress haven’t repealed or replaced Obama Care, but the Trump Administration still has an obligation to help Americans facing higher premiums and fewer choices. One incremental improvement would be rescinding regulations on temporary health-insurance plans.

Sen. Ron Johnson (R., Wis.) this summer sent a letter to the Health and Human Services Department about an Obama rule on short-term, limited-duration health insurance plans, which as the name suggests offer coverage for certain periods, often insuring against hospitalizations or other unexpected events. A person could hold such a plan for 364 days, but a rule issued last year limited the duration of the policy to a mere 90 days, effective April 1.

The reason for the restriction is straightforward: coercion. These plans are useful options for someone who loses a job or is otherwise without coverage, and until recently an estimated 650,000 to 850,000 people were in the market at any given time, with an average policy duration of five or six months, as the Johnson letter notes. Yet the Obama Administration nixed this choice to push individuals into ObamaCare’s exchanges.

Mr. Johnson’s letter points out that HHS explicitly said in the Federal Register that stopgap plans might target the young and healthy, “thus adversely impacting the risk pool for Affordable Care Act-compliant coverage.” Recall that the law’s central conceit is that healthy individuals must be forced to subsidize the aging and sick, or the exchanges will tank.

The short-term plans don’t count as minimum coverage under the law’s individual mandate, which means policyholders are subject to the tax penalty. Yet the irony is that before the new rule, many individuals still chose to pay the penalty in exchange for the flexibility of benefits the short-term plans offered.

Health and Human Services could restore the duration length to a year and allow the plans to satisfy the coverage mandate. The point is to recreate some portion of the individual market that the Affordable Care Act destroyed. Short-term plans have traditionally been a small share of the insurance market, but perhaps more consumers will sign up as insurers continue to flee the ObamaCare exchanges and premiums continue to increase.

One question is political. Congress failed to replace ObamaCare, and Republicans fear they will now own all problems with the exchanges. The Trump Administration may thus be reluctant to revoke regulations that exist to sustain the ObamaCare status quo.

Yet no one expects this discrete change to topple ObamaCare, and the law’s dysfunctions will compound in any event. The damage from the GOP’s reform failure will continue to radiate in ways that are hard to predict, but the Administration’s best move now is to offer consumers as many health-care choices as possible.

Appeared in the August 15, 2017, print edition.

Aug. 14, 2017 7:27 p.m. ET


How employers should deal with health reform uncertainty

With the collapses of the GOP’s efforts to repeal and replace the ACA there’s real uncertainty right now around U.S. healthcare policy. And this comes at a time when employer and employee decisions about their 2018 benefit offering need to be made is quickly approaching.

Even in the face of this uncertainty, however, there are steps companies can take now to prepare for the longer term.

Prepare for how the IRS will respond to and enforce policy changes

One key concern is the enforcement of the ACA’s core requirement that companies offer health insurance to employees working over 30 hours per week. Under this requirement, employees that opt out of health insurance are required to pay a tax. What is still unclear, however, is whether or not the Internal Revenue Service will enforce the law as it is currently written.

The Department of Health and Human Services has already started sending notices to employers about such cases, while the IRS has yet to send related tax bills. Given the IRS was already having technical issues calculating taxes under the ACA before the current administration came to power, now it’s unclear if these bills will ever be sent.

[Image credit: Bloomberg]

[Image credit: Bloomberg]

Given the ambiguity of the situation, employers should remain compliant and continue to file all ACA-related paperwork until they are explicitly told otherwise by government officials.

Anticipate part-time workers to push for employer-sponsored health insurance

As government spending on healthcare continues to decline, employers should anticipate part-time employees who have previously received subsidies for purchasing health insurance via health exchanges will ask their employers to sponsor their health coverage.

To reduce federal regulation, the administration may seek to reduce or eliminate the subsidies that were put in place by the ACA for coverage purchased on the health exchanges, including withholding a class of payments to insurance companies called cost-sharing reductions (CSRs). This was a common goal of the House bill and the initial bill released by the Senate even while industry experts advise that removing CSRs will destabilize the individual insurance market.

With this in mind, we can expect that if the ACA marketplace collapses, given Trump continues to push for a reduction or elimination of CSRs, part-time and temporary staff will want alternative coverage with discounted insurance that is no longer available on the exchanges.

Evaluate potential changes to benefits if the employer mandate is repealed

Another key aspect of the ACA which is under debate is the requirement that employers with 50+ employees must offer full-time employees health insurance. It’s important for companies to start to consider now how they would react if the employer mandate were repealed.

Offering insurance to fewer employees or switching to less generous plan structures could help reduce employer expenses. Alternatively, employers can offer employees an array of plans, from “skinny” to more comprehensive options.

In the event the employer mandate is repealed, it is likely that many employers would keep their current insurance programs in place, at least in the short term.
This is largely due to offerings on the exchange not being comparable to the group health market.

This is why it would not be beneficial for organizations that employ a large number of low-wage workers to consider dropping insurance on the assumption that their employees will be able to buy subsidized policies on the exchanges.

Consider high-deductible plan options

Many aspects of the replacement bills being brought forth encourage policies that have more limited benefits and higher deductibles than typically offered under current law.

A possible response is to raise contribution limits for health savings accounts, which give participants a way to cover the higher out-of-pocket expenses that come with high-deductible health plans.

In an effort to retain employees and avoid having a mass exodus of workers leaving for companies with richer benefits, employers may choose not to increase the deductibles on their plan offerings. However, given the uncertainty and frequent changes in these policies, benefit managers should be prepared to reduce benefits if these changes to the ACA materialize.

Understanding the tradeoffs between keeping your current benefit design and moving to a plan that offers less coverage or higher deductibles can mean staying ahead of the curve in these uncertain times.

  • August 09 2017, 12:13pm EDT

Michael S. Grant

Michael S. Grant leads the Employee Benefits Services unit for Crystal & Company as Executive Managing Directo

Employers embracing health cost reduction measures

Large employers expect health benefits costs to increase 5% in 2018 and cost $14,156 per employee — a rise that is pushing companies to look at ways to rein in costs.

It will be the fifth consecutive year of 5% increases, according to the National Business Group on Health’s Large Employers’ 2018 Health Care Strategy and Plan Design Survey, released Tuesday. Of the predicted total cost for 2018, employers will cover almost 70%, while employees will be responsible for 30%. With the expected hike, employers are setting their sights on a robust set of services — from telehealth to on-site health clinics — to help curb rising costs.

“We’re seeing an increased focus on the consumer experience within the healthcare system,” says Brian Marcotte, NBGH’s CEO. “Employers have come to the conclusion that as much as [they’d] like for employees to be sophisticated consumers of healthcare, the system is way too complex, way too fragmented and they don’t touch it with enough frequency to ever be sophisticated consumers.”

Brian Marcotte, National Business Group on Health CEO

Brian Marcotte, National Business Group on Health CEONick Otto

He says that realization, combined with information from the new report, is leading employers to look at catered services to help employees understand benefits, understand their treatment options and to know where to go for care.

According to the survey, 66% of companies will offer medical decision support and second opinion services in 2018, an increase of 47% from this year. Additionally, the number of companies offering high-touch concierge services will jump from 28% this year to 36% in 2018.

Offerings of e-health services continue to grow. Virtually all employers (96%) will make telehealth services available in states where it is allowed next year, according to the study. Further, more than half (56%) plan to offer telehealth for behavioral health services, more than double the percentage this year.

Utilization of these programs also is growing, with NBGH reporting nearly 20% of employers experiencing employee utilization rates of 8% or higher.

An Rx for savings

For the second year in a row, specialty pharma continues to be the biggest driver of healthcare costs for employers.

“Managing these high cost drugs is a top priority for employers next year,” Marcotte says. To help control these spiking specialty pharmacy costs, 44% of employers say they will have site of care management tactics — ensuring medications aren’t administered at more costly settings —in place next year, a 47% increase over this year. Additionally, seven in 10 employers will use more aggressive utilization management protocols.

The NBGH study dovetails alongside another survey from Willis Towers Watson released recently, which also found employers are increasingly spending more on healthcare benefits.

The WTW study found that despite the uncertainty about the future of healthcare legislation, employer confidence in offering employee healthcare benefits has reached its highest level since the passage of the Affordable Care Act in 2010. Ninety-two percent of employers said they are “very confident” their organization will continue to sponsor health benefits in five years.

“Employers understand that there is no single strategy for success when it comes to healthcare, and it is critical to engage employees through education and communication that will create a win/win,” says Catherine O’Neill, a senior healthcare consultant at Willis Towers Watson. “The most effective health programs will include a broad range of strategies that encompass employee and dependent participation, program design and subsidy levels, and plan efficiency. The ultimate goal is to offer a high-value plan that manages costs for both employers and employees while also improving health outcomes.”

  • August 08 2017, 10:40pm EDT

Health Experts Push Fix for Insurance Markets Aimed at Both Parties

Policy-adviser group offers plan to stabilize insurance markets as lawmakers consider bipartisan overhaul

A bipartisan group said they are pitching a plan to stabilize ACA’s insurance markets to lawmakers including Sen. Lamar Alexander, left, and Sen. Patty Murray
A bipartisan group said they are pitching a plan to stabilize ACA’s insurance markets to lawmakers including Sen. Lamar Alexander, left, and Sen. Patty Murray PHOTO: BILL CLARK/ZUMA PRESS


WASHINGTON—A bipartisan group of health policy experts offered a proposal Wednesday to stabilize the Affordable Care Act’s fragile insurance markets, a blueprint intended in part to provide cover for lawmakers seeking to work across the aisle.

The group, composed of prominent advisers to former Republican and Democratic presidents, began holding monthly meetings in January to search for points of agreement on a possible package to address rising premiums and insurers leaving the individual insurance market.

In a Wednesday call with reporters, leaders of the group said they are pitching it to lawmakers including Sen. Lamar Alexander (R., Tenn.), who chairs the Senate Health Committee, and Sen. Patty Murray (D., Wash.,) the committee’s top Democrat, who are working to craft legislation with similar goals.

“We hope that our being able to find a balanced set of recommendations will be regarded as important to members of Congress who will ultimately need to make any changes,” said Gail Wilensky, a former health policy adviser to President George W. Bush, who helped convene the group.

Other members, representing a range of ideological viewpoints, include Ron Pollack, the former head of families USA, a liberal health-care advocacy organization, and Lanhee Chen, former policy adviser to Republican presidential nominee Mitt Romney.

The plan makes five primary recommendations. It encourages lawmakers to formally authorize the ACA’s “cost-sharing reduction” payments, which help insurers subsidize costs for some low-income consumers. It recommends Congress ensure funding for the popular Children’s Health Insurance Program, which is favored by members of both parties but has been floated as a vehicle to pass more contentious health reforms.

The authors also endorse two GOP-backed ideas—expanding the use of health savings accounts and broadening the ACA’s state innovation waivers, to give states additional flexibility in administering their insurance markets.

In exchange, they nod to a core priority for Democrats to have a mechanism that will entice more people to sign up for health insurance. Critics of the ACA have long derided its requirement that most people enroll in coverage or pay a penalty, and the group recommends that some states be permitted to waive it in favor of different tools.

The plan comes as the White House is considering its options on health care, particularly whether to bolster the ACA’s insurance markets. Some lawmakers in both parties say the markets can’t be allowed to weaken further, but the critics argue that nothing should be done to bolster the law.

The bipartisan group’s proposals are unlikely to satisfy some conservatives who favor a full-scale repeal of the ACA, also called but Obamacare. But they could give a boost to Mr. Alexander, who has announced plans for bipartisan hearings in September on the individual market, over the objections of some in his party.

The individual market—where people who don’t get insurance through work can buy coverage—is a current focus of lawmakers seeking a path forward following the collapse of the Republican health care push. Some insurers have been pulling out of the market, citing their uncertain future.

Senate Majority Leader Mitch McConnell (R., Ky.), who would need to allow any legislation crafted by Mr. Alexander to come up for a vote, has expressed skepticism about the senator’s intention to fund measures stabilizing the market without loosening the ACA’s regulations.

Aug. 9, 2017 2:48 p.m. ET

Write to Michelle Hackman at

The 5 surprising skills HR will need in the future

The role of human resources is going through a major shift. In the past, HR concerns took a back seat to bottom-line business needs. This was due in part to a lack of strong HR metrics and ways of measuring them and, on the other side, the balance of power between employer and employee. However, today, in the increasing scramble for top talent, the C-level has woken up to the importance of employee engagement, retention and development.

The impact of employee engagement on loyalty, productivity, innovation and customer satisfaction has revealed that an engaged workforce is not simply a nice-to-have, it’s a necessity for creating an innovative business that can withstand the constant flow of new competition.

This has led executives to look to HR to recreate and drive the shift toward employee-centered processes, environments and strong value-based cultures, otherwise known as the employee experience. However, a gap still exists between translating data into actionable changes. Employee engagement is an abstract metric. Identifying a dip in your most recent engagement survey may not yield the information you need to find out why your people are less satisfied with their work life than the month before and how to address it. The challenge HR faces today is how to make people data human.

At this game-changing moment, HR leaders need to open their mindsets to new ways of designing processes to create a totally customized and unique experience. The great thing is you won’t have to leave your organization to acquire the new skills you need. Here are five things HR and benefits executives can learn from other departments.

1. Marketing: Understanding the employee journey

Marketers have been successful in better understanding the mindset and emotions that occur throughout a customer’s journey with the company and the product. By creating customer journey maps, they’ve found a way to categorically track each touchpoint a customer goes through until they make the decision to buy. Studies have found that even one negative experience can actually deter customers from going through with a purchase. In fact, Oracle found 81% are willing to pay more for a better experience. Furthermore, as marketers know, maintaining customers is more cost effective than actually acquiring new ones, making customer mapping extremely valuable.

What many HR leaders have found is if you replace “customer” with “employee” you get a similar effect. A negative experience with recruitment portals has been shown to deter potential hires from applying for positions. Many millennials are willing to forgo a larger salary for a better quality of work life. In fact, a recent survey by Fidelity Investments revealed that, on average, this new young workforce would be willing to take a $7,600 pay cut in exchange for immaterial incentives like purposeful work, work/life balance and company culture. Finally, similar to customer retention, retaining employees is proven to be more cost-effective than recruiting and retraining new people.

Given the success that marketers have had from creating customer journey maps many HR leaders are now utilizing this methodology to create employee journey maps, tracking each phase from recruitment to exiting the company.

2. Statistics: People analytics

Once you have your journey mapped out, it’s time to fill it in with the factors that are most important to your work environment. The best place to start is by collecting data. Where are you falling short and where would you like to improve? Are you having trouble attracting new hires? Is your goal to help develop more female leaders within the company? Do you see a dip in engagement after your annual performance review? The key here is to be collecting data regularly. An engagement survey taken at the beginning of the year won’t reflect the attitudes that developed during your company’s sudden leadership change in March. The more data you have the easier it’ll be to compare and identify potential causes.

Luckily, for us non-math people, an array of new HR tech gadgets makes capturing and analyzing data even easier. Need to find out how much time your managers spend on coaching or who the top performers are in your company? With the rise of HR technology, there’s bound to be a solution that can make your life easier by collecting, analyzing and sending the data you need.

See also: Benefits technology spending increases as options grow

3. Psychology: Creating personas

Again, the idea of creating buyer personas originally comes from marketing but can be extremely useful when mapping out your employee journey. Rather than thinking of your workforce as a whole, creating specific employee personas brings the human side to the process, enabling you to visualize each stage from the viewpoint of a specific person. This requires you to get into the mindset of the typical employee or the ideal hire and identify key concerns they may have at each stage.

Rather than looking at your workforce as a whole, thinking about a specific person with a name, role and personality will help you to step into their shoes and get a better sense of what they could be experiencing. How does Jane feel about your performance review process? What factors could be inhibiting her from gaining the growth benefits this practice should provide?

4. Design: New ways of thinking

Once you’ve identified the potential pain points in your employee’s journey, it’s time to rethink processes and propose new strategies specifically designed to eliminate these barriers. Design thinking can help you. Deloitte’s 2016 Global Human Capital Trends found that HR departments that provided the most value were 5 times more likely to be using design thinking. The exciting possibilities that can be opened up with design thinking have even flowed upward with 79% of executives rating it as an important or very important issue.

After analyzing the pain points identified, designers put themselves into the mindset in order to create UIs that will enable a comfortable and engaging experience for users. This means departing from traditional models of onboarding and performance management, which have been HR cornerstones for decades.

5. Communications: Storytelling

Storytelling is a key skill every HR manager needs to learn. While executives have awoken to the importance of metrics like engagement, HR continues to face the struggle of putting their ideas on the agenda. Even if the C-suite wants the department to solve the engagement problem, selling the major overhauls you would like to make to traditionally ingrained processes will not be easy.

What we have to remember is that people analytics is not just data. This information tells a story about the people in your company. HR’s role as a storyteller is essentially to translate this information into (at times provocative) stories that explain to the executive level what your employees are going through and what the company needs to do to improve. Learning this skill will pave the way for the new designs you have in store for your company.

The most important skill HR will need to learn is how to make HR data human. Low engagement cannot simply be solved by offering a new ping pong table or better lunches. Getting other departments to share their learnings will allow you to upskill your team and get HR that seat at the table.

  • August 07 2017, 12:04pm EDT

Steffen Maier

Steffen Maier is co-founder of impraise a web-based and mobile solution for actionable, timely feedback at work.

Insurers Say They Need More Federal Funds

U.S. Senate Minority Leader Sen. Chuck Schumer speaks to the media at the Capitol, August 1.
U.S. Senate Minority Leader Sen. Chuck Schumer speaks to the media at the Capitol, August 1. PHOTO: ALEX WONG/GETTY IMAGES


The Coming ObamaCare Bailout” (Review & Outlook, Aug. 3) exploits a political buzzword to argue for a policy that would further destabilize the individual insurance market. Let’s look at the facts.

First, health plans do not keep a single dime from this program. This funding is passed directly through to doctors, hospitals and pharmacies on behalf of patients—and only for care that’s actually provided. Hardly a bailout.

Second, eliminating this funding now would create something akin to an unfunded mandate. If health plans are required by law to offer these lower deductible and cost sharing plans to lower-income people without being reimbursed, this de facto mandate on the private sector will drive up premiums by approximately 20% for all consumers who purchase their own coverage.

Third, eliminating this funding now would hurt states, doctors, hospitals and hardworking taxpayers. Recent studies show that the resulting higher premiums would cost taxpayers $2 billion more in additional spending. States, as shown by a federal court decision earlier this week, would face new uncompensated care costs because public hospitals would care for more uninsured patients. Same goes for many doctors.

It’s time to focus on real solutions. Let’s keep the market stable so that Congress, the administration and the private health-care sector can work together on long-term solutions that actually work. Otherwise, there may not be an individual insurance market to improve.

David Merritt

Vice President of Public Affairs

America’s Health Insurance Plans