Communications Strategies: The Maryland Experience

1. 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

2. 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

3. 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

4. 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

5. 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

6. WhatWorked • 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

7. 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

8. 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