« June 2013 Issue

A Conversation on Emerging Issues: Outreach and Enrollment

On October 1, 2013, millions of Americans will have a new opportunity to purchase high-quality, affordable health insurance plans for themselves, their families or small business through Health Insurance Marketplaces in each state nationwide. It will take a tremendous effort to educate, enroll and assist consumers through this new process. The stakes are high and consumer health advocates will play a critical role making sure outreach and enrollment is a success. To learn more about Community Catalyst's work in this area, we sat down with Susan Sherry, Deputy Director.

Why is Community Catalyst thinking about outreach and enrollment now?

This [the Affordable Care Act] represents one of the biggest expansions of coverage we've seen since Medicare and Medicaid. Currently, there are a lot of uninsured people who need coverage, their health needs aren't being met and they are financially insecure. We know from our experience in Massachusetts and with other states that there's a lot of work involved in letting people who've never had coverage know that it's available. Many uninsured people are working more than one job; they have busy and overwhelming lives.

What are some of the challenges in educating the public about new coverage options?

We know for a fact that there is little solid knowledge and information that has reached the public about the ACA. In addition, many people are unfamiliar with insurance because they've never had it. Insurance can be intimidating to the most well-informed of us! Add to that the fact that some people might have limited language skills and varying education levels. There is a lot of work to be done just to let people know coverage is available, explain to them what it is, and support them in applying, and selecting which coverage plan to pick.

What do we already know about best practices and what advocates can do to prepare?

You need to bring people and organizations together who already have a relationship with each other and are interacting with the uninsured. And that's community health centers, hospitals, community agencies that serve people already, schools, and churches. Part of it is getting information to the institutions and community organizations and people communities interact with and trust. But those organizations are not necessarily experts in health care. We know from Covering Kids and Families - when CHIP (the Children's Health Insurance Program) expanded - there were some basic things that were effective. First was to get all those people together, and second was to develop a coordinated education and outreach campaign that identifies who needs to be reached, who will create shared training and materials, and who will develop media campaigns to target certain populations.

It's really important that health advocates pull together their own community-based organizations and stakeholders and develop a state-specific plan that makes use of what is in place, identifies the gaps, and determines how to fill those gaps. Everyone will need to make efficient use of resources - and Community Catalyst will work to help them do this.

Are there specific lessons to be learned from our experience in Massachusetts?

Yes there are. You need to invest resources in all the elements: education, outreach and consumer assistance. Having a coordinated coalition matters and utilizing trusted community organizations and getting them support and resources helps. And we know that people will need in-person assistance. The Health Care for All HelpLine was viewed across the board as a positive thing both before and during enrollment. Once enrollment started, they got 4,000 calls a month. State agencies referred to the HelpLine and community groups viewed the HelpLine as critical back-up resource.

Having a cooperative feedback loop with state and federal governments is also important to identify peoples' experiences and give feedback when there is a glitch. For example, is a specific application form hard to use? Getting that feedback quickly to the people who developed the form is important.

What role does Community Catalyst hope to play?

We're playing multiple roles so far! Through our current Consumer Voices for Coverage initiative we are going to be able to give, thanks to the generosity of the Robert Wood Johnson Foundation, supplemental resources to targeted states so advocates have the capacity to bring people together and develop their state plan. This will mean anything from dollar resources, training, sharing best practices, planning templates, or materials and examples from the Health Care for All HelpLine. Our Affordable Care Act Implementation Fund will also be funding states to do outreach and enrollment, and the two efforts will be closely coordinated. From the ACA Fund, we will be funding "leader states" where outreach and enrollment is front and center as well as other states that haven't expanded Medicaid yet. We believe that outreach and enrollment campaigns can serve as an advocacy opportunity for pushing for full Medicaid expansion.

We are also coordinating closely with other national partners to identify the resources needed for outreach, education, and consumer assistance. We are talking weekly with Enroll America, a newer organization that is doing outreach in target states. We are talking to Planned Parenthood, SEIU, National Council of La Raza - all organizations who have local affiliates on the ground. Our job is to share best practices and establish active learning communities on the ground in the states and then bring those lessons to the table.

O N   T H E   W I R E

Jessica Curtis, Hospital Accountability Project director, told the Associated Press that hospitals continue to use unfair billing and debt collection practices, despite Affordable Care Act Provisions.

Jacquie Anderson has been promoted to Chief Operating Officer. Jacquie previously served as Director of State Advocacy. She has been with Community Catalyst for more than 15 years and brings more than 20 years of experience working with community organizations.

Community Catalyst released a report assessing the economic viability of midlevel dental providers. Midlevel dental providers practicing in Alaska and Minnesota cost their employers less than 30 percent of the revenue they generate.

The Prescription Access Litigation Project led a successful campaign urging the Supreme Court and Congress to end to pay-for-delay deals between brand name and generic drug manufacturers that prevent consumers from getting timely access to affordable prescription drugs.

Christine Barber, senior policy analyst, explained in The New York Times that given the high number of people unaware of their new health care options, advocates, providers and other stakeholders must work together to make enrollment a success.

In April the Community Catalyst Board and members of the staff joined together to celebrate the contributions of outgoing Board member and longtime supporter, Stephen Rosenfeld. Steve has been and continues to be a leading and powerful advocate for consumers in the health care reform movement.

In May, current Board member Wendy Warring and her husband Troyen Brennan hosted a fundraiser in their home in support of Community Catalyst. The event was a tremendous success and we are grateful to Wendy and Troy for their care and generosity.

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