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ACA Round Two: Outreach challenges and promises

Getty Images - Healthcare enrollmentChanging rules, technical issues and lack of awareness of the newly enacted Affordable Care Act (ACA) among consumers contributed to a difficult first enrollment period. But this next open enrollment period, now a month away, will bring new challenges to this already complicated enrollment process. Access Health CT (AHCT) estimates that 70,000 more people will seek coverage by February 15, 2015.  Additionally, they hope to engage those needing to renew their coverage, as well as reach the 4% of CT residents who remain uninsured.

Community leaders have a number of concerns related to AHCT efforts to address the needs of the uninsured.  “These are the people who are not connected to agencies, associations or churches. And I don’t see an outreach strategy to attempt to reach these people,” said Alta Lash, AHCT consumer advisory board member and Executive Director of Caring Families Coalition.

“The folks who need help are probably very poor and are eligible for Medicaid, but don’t know it. Who’s going to be responsible for them?”

Lash believes its AHCT’s responsibility since people are going through the exchange to get coverage.

However, at the September AHCT board meeting, chief marketing officer Jason Madrak revealed that the outreach plan does not include the three million dollar Navigators and In Person Assistance (NIPA) program that was funded to provide in-person assistance.

Several local and national reports overwhelming support the value of in-person assistance, especially in engaging harder to reach communities. In-person assistance helped make the enrollment process more successful, resulting in a 50% decline in the uninsured rate in Connecticut after the first year of enrollment.

“The major change is that Access Health expects people to go to them, rather than going out to people. They are setting up store fronts and hiring a few people across the state in places where data shows a large number of people who are uninsured,” Lash explained.

“They are expecting people to just come into the door, and the chronically uninsured people are just not going to do that. They didn’t do it last time, so they are not going to do it this time.”

Organizations such as Eastern Connecticut Area Health Education Center (Eastern CT AHEC), a non-profit health organization that was one of six funded navigator organizations last year, are also expressing concerned about the lack of the in-person assistance program during this round of open enrollment.

“I think one of the challenges this year is that there hasn’t been ongoing engagement with consumers. There’s a real lack of presence, especially in the eastern part of the state,” said Maritza Bond, Executive Director of Eastern CT AHEC.

“I know that healthy chats are happening, but it’s only taking place now which is almost too late in the game to engage consumers in this process.”

Bond is also concerned about the lack of awareness from consumers, particularly those who are not “tech-savvy” and with access to the internet.  “Many people are not aware of the process of renewal that they will be required to do,” she added.

Bond’s concerns fit with much of what health leaders are saying nationally about this open enrollment period. A new survey from the Kaiser Family Foundation highlights this challenge in that it found 89 percent of uninsured individuals are unaware that open enrollment begins in less than a month.

When asked how her organization is preparing for open enrollment without funding this year, Bond replied that they are planning to apply for a small grant in the amount of $5,000 to have a dedicated staff person work with consumers.

Bond acknowledged that this is not enough to meet the needs of the community, but with the limited resources they have this year, they are forced to be strategic and very focused with their outreach activities.

One of the newer promises for open enrollment this year is that three local foundations have recently pitched in to support the work of in-person assistance in small $5,000 grants totally $150,000 in funding. The foundations recognize the importance of in-person assistance in engaging hard to reach communities and plan to fund 35 outreach workers.

“Hope is alive,” tweeted CT Health Foundation’s Vice President of Communications and Policy, Elizabeth Krause. The funding announcement is said to be available next week.

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Image credit: Getty Images

About Heang Tan

Heang Tan is the project director and editor for HealthJusticeCT. You can find her tweeting about health equity and other random things @heangtan

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