Restaurant industry a key to transforming health care access in America
More than 40 percent of uninsured Americans are 18-34 years old. For the Affordable Care Act (ACA) to be a success, young adults need to enroll, not only because they make up a disproportionate share of those without health care coverage, but also because they are needed to balance the risk pool. To date, one-fourth of the 3.3 million enrolling through the health care exchanges are young adults. This is below the desired 35-40 percent ratio needed to keep premiums low.
Young adults are the largest employee segment of the restaurant and foodservice industry. As the nation’s second largest private sector employer with 13.1 million individuals, or 10 percent of the entire U.S. workforce, 43 percent of the workers are under age 26 and an estimated 65 percent of all workers are under age 35.
There is a prime opportunity to target this industry group to advance health care for all. Resources should be flowing to ensure restaurant and foodservice workers are being made aware of the exchanges, about how to enroll, and the potential to receive federal subsidies.
However, applying the ACA in this industry is no easy task. Offering health coverage at the same time as pressures mount to raise the minimum wage is a problem in an industry that operates with low profit margins. In addition, this is a workforce with relatively high turnover (averaging 50-60 percent annually), with part-time, variable-hour and seasonal employees, and with complex ownership structures.
Providing health coverage at large national restaurant brands is difficult enough. But even greater challenges exist for owners, operators and franchisees who are at or around the 50 full-time equivalent threshold that qualify them as large employers, or those with perhaps one or two restaurants or locations, or with plans to open a third. These are some of the employers who may not have been able to offer health coverage. For those who do, often their employees go without it because they work part-time, or are temporary, haven’t yet met probationary or waiting period requirements, or can’t afford coverage.
Research conducted by Georgetown University’s Global Social Enterprise Initiative for the National Restaurant Association indicates that owners and operators across the country say they want to offer health benefits or help their employees understand and access the best coverage choice for them and their families. But, restaurants face considerable uncertainty regarding the impact of the new law on their business costs, largely because they do not know what choices their employees may make. (Read more HERE.)
Will young workers opt to be on their parents’ insurance plan? Pay the individual penalty? Or take their employers’ coverage? Will these “young invincibles” act as they always have and place health care among their lower priorities, given their relative good health and job status? Will they even bother to check out their options because they think all insurance is unaffordable?
A study by eHealthInsurance reports that only 17 percent of Millennials (18-32 year olds) consider themselves to be well-informed about health care reform. Another recent survey by the Harvard Public Opinion Project (HPOP) shows that Millennials are ambivalent about the ACA. Only 20 percent intend to enroll through an exchange. Nearly half (47 percent) do not intend to enroll, and another 28 percent are undecided. These are daunting challenges to overcome. But, there is a path to a potential solution.
The National Restaurant Association and State Restaurant Associations have taken several steps to help their members comply with the law. These include developing programs and services to help restaurant and foodservice employers with notification, tracking and communication to employees about how to enroll in either employer-sponsored offerings, federal or state exchanges; or seek a health care plan from a private exchange.
There are opportunities for the National Restaurant Association to go even further. The industry could develop a “navigator corps” of trained specialists who travel to restaurants and provide on-site assistance with signing up. Coordinated local and regional health care enrollment fairs with navigators servicing multiple restaurants and employees should be considered. Other tactics are to provide peer-to-peer learning environments for owners and operators to share useful information. The government can help by providing tax credits to companies with part-time employees who dedicate work time for their employees to learn whether they are eligible for subsidies through an exchange. These are just a few examples of how restaurant owners, caterers, and others who want to help get the assistance they need to guide their employees — young and old — to get access to health care.
The restaurant and food service industry and the Obama administration have something in common: both want the broadest possible health insurance coverage for those who need it.