Health Center News, Uncategorized

Update on Outreach and Enrollment

Our guest blogger today is Ted Henson, Director of the Robert Wood Johnson Outreach and Enrollment Project, with a progress report on  health center patients and insurance.

NACHC recently conducted a poll of enrollment assisters and staff at Community Health Centers about the second open enrollment (OE2) under the Affordable Care Act (which turns five years old this week).

A vast majority of the 377 respondents — 84 percent— reported that the second enrollment period (OE2) met or exceeded expectations in terms of total enrollment assists and that there was a reduction in problems overall. Of the 111 respondents from states that participated in the federally facilitated exchange (, nearly 91 percent reported that OE2 met or exceeded their expectations.  On the other hand, the poll also revealed persistent challenges for new enrollees when it comes to accessing care. Nearly 84% of respondents said that the overall cost and affordability of coverage remains a major obstacle that prevents new enrollees from utilizing their benefits and accessing coverage.

Some key trends have also emerged. During the first open enrollment period, many consumers who were assisted by certified application counselors, navigators, and other staff at health centers were enrolled into the low-premium but high-deductible Bronze plans.  But the trend shifted during the second enrollment period.  Over 71 percent of assisters now say a majority of people enrolled into Silver-level plans or higher due to premium tax credit assistance and/or other factors. Eighty-one percent of respondents in states that did not expand Medicaid reported that a large majority of people enrolled into Silver-level plans or higher and fewer people enrolled into Bronze plans.

Despite the boost in the numbers of people choosing Silver plans, some assisters reported that the renewal process was problematic and, in some cases, resulted in many people losing coverage.  Also Silver plans were not available in some areas, and even if they were, they were still unaffordable despite the APTCs in some states.

While cost and affordability were the biggest obstacles for new enrollees in terms of  accessing their care, 56 percent of respondents reported that a lack of understanding of the general healthcare costs covered by insurance posed a significant challenge for new enrollees. Also over half (52.3 percent) reported that many people lack a thorough understanding of insurance terms and how to use insurance.  Other issues cited included password recovery and reset issues, significant technical glitches in several state-based exchanges, and a lack of access to in-network providers.

In terms of what’s next for enrollment, nearly all respondents (93.7 percent) reported that assisting consumers qualifying for a special enrollment is a priority or major priority going forward. The federal government announced a special enrollment period (SEP) for tax season from March 15 – April 30, 2015 in states that utilize Health insurance literacy is also a major focal point of ongoing efforts: 53.6 percent reported that assisting consumers with understanding their coverage is a priority, and an additional 35 percent said it is a major priority.

For more information about this poll or NACHC’s ongoing efforts on O&E, contact Ted Henson: