Until recently, estimates indicated that more than half of US citizens obtained health insurance through their employers. Yet the employer-based system left many vulnerable populations, such as low-wage and part-time workers, without coverage. The changes brought into effect by the Affordable Care Act (ACA) of 2010 have had a substantial impact on the provision of employer-based health care coverage.
Because health insurance is so intricately woven with employment, social workers in employee assistance programs (EAPs) are positioned to assume an active leadership role in guiding and developing the needed changes to employer-based health care that is occurring due to health care reform. In a recent article in Health & Social Work, Susan Frauenholtz, MSW, MHRIR, argues to social workers in EAPs to take the lead in shepherding the changes and adjustments employees can make in their coverage.
Frauenholtz’s article first covers a brief history of EAPs, and then looks into the ACA and the changes in coverage it mandates. After laying this foundation, she proposes the roles that social workers in EAPs can take in responding to the ACA-mandated changes. She outlines three components of the social work response:
- Education: All social workers in EAPs need to educate themselves about the law and its potential impact on how their respective workplace organizations allocate healthcare benefits. Then the social workers can provide ACA education to employees and assist them in learning about the impact the law could have on their own health care benefits. EAP social workers can guide employees in determining their own and their families’ health care needs to make informed decisions about the best available health care plan.
- Advocacy: Engaging in advocacy efforts to assert the rights of vulnerable employees is essential to the success of the health care reform effort. EAP social workers must advocate for employee needs within the organization and empower employees to advocate for their own behalf as health care benefit restructuring is considered.
- Brokering: Should an employer choose to discontinue health care benefits for some or all employees, EAP social workers can act as brokers for their clients, assisting them in ascertaining their specific health care needs, choosing an insurance exchange option best suited to meet those needs, and linking them to that health care coverage.
All these areas represent great opportunities for EAP social workers to assist employees in learning about and utilizing their health care options. Frauenholtz stresses:
Social workers in EAPs must be prepared for resistance to their expanded role in some workplace settings.… [T]he financially driven business goal of increasing company profits can conflict with social work’s mission of empowering people and creating social and economic justice. Although it appears that the ACA presents the unusual opportunity for the goals of business and social work to be congruent, inconsistent goals will likely emerge. By taking an active role in the workplace that extends beyond the traditional confines of EAP work, social workers might face resistance from human resource managers who could interpret the efforts of EAP social workers as an encroachment on their area of workplace domain. By preparing for these potential obstacles and actively marketing their expertise to employers, EAP social workers can provide an effective response.