If there is one word that describes the current debate in Congress over the proposed American Health Care Act (AHCA), it is uncertainty. Almost everything about the proposed bill is currently unclear, including whether it will pass, what it will look like if it does, and how it will affect people if it does get signed into law.
Nearly all of the conversations about the effect of the proposed law, however, have been about its impact on consumers currently insured through Medicaid or public exchanges who are at risk of losing their insurance. With 24 million set to lose coverage in the next decade, according to the nonpartisan Congressional Budget Office, those are worthy concerns.
However, relatively little attention has been paid to the effect the AHCA could have on the millions of Americans who get their health insurance through their employers. About half of Americans are covered through employee based health insurance, according to estimates from the Kaiser Family Foundation. Of those who are employed full-time, 52.4% rate anxiety about healthcare as their greatest current economic anxiety, according to a Marketplace Edison Research Survey conducted in April 2017.
Why Employees Are Stressed
These employees are stressed about health care for a number of reasons. Chief among them is a worry about the law’s potential to change essential coverage, for instance, by removing coverage for preexisting conditions. More than 50 million Americans under the age of 65 have a preexisting condition, and these conditions drive 85% of health spending. By ending the requirement for a basic set of essentials to be in all insurance policies, employees might have to pay an indeterminate amount to gain coverage for things that are currently covered for “free.”
The law could also create more options for health savings accounts (HSAs), which are touted as a way for consumers to take more control over their own healthcare payments. In effect, however, they are often paired with high-deductible plans and a “use it or lose it” annual provision that creates anxiety for employees about how much to contribute to cover their needs. In addition, HSAs could create more economic worry by forcing consumers to decide between saving for health care and saving for retirement.
Even employees who know their health benefits won’t change may have uncertainty about how to care for their elderly parents, self-employed spouses, their child with asthma, or their possible future pregnancy. This uncertainty could also affect those considering a job change to a new employer or to becoming self-employed, as well as those about to retire.
Anxiety about all of these concerns—whether the AHCA ultimately comes to pass or not—is already having a real impact at work, causing many employees to struggle to remain productive and engaged. Luckily there are things that employers can do to mitigate this strain. At a minimum, employers should prepare to be transparent, empathetic, and proactive in clearly spelling out how any changes in the healthcare law could affect the coverage they are able to offer to their employees.
How Employers Can Help
There is more that employers can do in assisting employees coping with the anxiety over health care, including helping them learn how to be resilient in the face of uncertainty and face decisions with an agile mindset. Resilience training helps to manage anxiety and worst-case-scenario thinking by teaching employees to replace negative ways of thinking with positive habits and thoughts, including:
- Recognizing when they are ruminating on worry and anxiety. By observing their thoughts, employees can catch themselves when they are falling into rumination, and use a three-step process to “trap it,” “map it,” and “zap it”—that is, trapping an emotion by identifying it, mapping it onto the thought that caused it, and zapping it by challenging the thought.
- Avoiding automatic thinking traps. While employees may have legitimate concerns for the future, they only make matters worse by falling into worst-case thinking that overemphasizes the negative, personalizing a situation by blaming yourself, externalizing by blaming someone else, or over generalizing by taking one piece of information and extrapolating a general rule. Any of these traps can ultimately be paralyzing and create an impediment to dealing with a situation.
- Prepping for future with ‘if/then’ contingency planning. Employees can take control over their situation by looking ahead to possible scenarios, and planning out what they will say or do if and when these situations play out. Studies have shown that people are two to three times more likely to succeed if they have an “if/then” plan than if they don’t. Even if a plan isn’t ideal, it can reduce employees’ anxiety knowing what they will do when a situation occurs.
- Using mindfulness techniques. Thousands of studies of brain function have shown that mindfulness meditation can be an effective tool in helping people gain awareness and perspective and control reactiveness to stressful situations. Even 10 to 15 minutes a day spent focusing on breathing or cultivating compassion through specific exercises can help reduce anger and spawn contentment that can make dealing with difficult decisions easier to manage.
Ultimately, there is little any of us can do at this moment to reduce the uncertainty over the American Health Care Act—or control the outcome on our health insurance if and when it passes. But when any new laws are finally passed, employers who have a more engaged and resilient employee population will be better able to collaborate with their employees to solve their health insurance problems and ensure the best possible health care for everyone.