Communications Strategies: The Maryland Experience SCI National Meeting Nicole Dempsey Stallings, MPP Special Assistant to the Secretary Maryland Department of Health and Mental Hygiene August 4, 2010

Background Working Families and Small Business Health Coverage Act (2007) Medicaid Expansion for Families – Began July 2008 –Income eligibility level increased from approximately 30% of FPL to 116% of FPL –Moved Maryland from near the bottom of states to above average Expansion of Benefits for Childless Adults (contingent on funding) –Primary Adult Care (PAC) Program –Phased in over three years Small Business Subsidy Program (Health Insurance Partnership) – Began October 2008 –Subsidy of up to 50% cost of premium for business with 2-9 FTEs, $50,000 average wage, and not offering coverage for 12 months –Wellness benefits and Section 125 Plan requirements –State administers the program through insurance carriers, offering employers a choice of carrier and plan

Challenges Targeting “non-offering” businesses Identifying appropriate venues for target audience Lack of advertising budget, yet aggressive enrollment projections Simplifying complex eligibility rules Intimidating topic for small businesses, without dedicated HR staff Addressing public perception State budget Economic downturn

Strategies Prioritize messaging and use focus groups Embark on statewide meetings for : –small business owners –health insurance brokers Capitalize on free press NEVER say “no” to a meeting request Build and reinforce essential partners to serve as Ambassadors to the program

Partnerships State and County Associations of Health Underwriters Business Associations and Chambers of Commerce Participating health insurance carriers State agencies –Local Health Officers –State and Local Departments of Business and Economic Development –Insurance Administration –Department of Labor, Licensing and Regulation Elected officials

What Worked Involving brokers early and often Partnering with business groups on regional meetings Using Governor to deliver key messages Identifying enrolled businesses to act as spokesperson Creating an informative and easy to navigate website Focusing on rural areas

What Didn’t Partnering with State Chamber or County Chambers of Commerce in affluent areas Partnering with stakeholder groups/advocates promoting Medicaid expansion Not budgeting for direct mail Not having list of “endorsed brokers” Things we couldn’t control –Legislators predicting future budget cuts in the press –ECONOMIC DOWNTURN

Lessons Learned Use venues appropriate to target audience Adapt material to site and audience –Messaging must be simple to understand, and linguistically and culturally appropriate –Not everyone will view reform(s) as positive Don’t underestimate the value of brokers when interfacing with small employers Coordination across state agencies is essential Don’t under-resource outreach and communication