Reprinted from INSIDE HEALTH INSURANCE EXCHANGES, a hard-hitting newsletter with news and strategic insights on the development and operation of federal, state and private exchanges.
By Steve Davis, Managing Editor
June 20, 2013 Volume 3 Issue 10
As of June 22, there will be just 100 days left until open enrollment begins. To coincide with that milestone, Enroll America on June 19 launched its national Get Covered America outreach campaign, and is hosting more than 50 events in 18 states.
The organization has begun hiring people in seven states — Arizona, Florida, Georgia, Michigan, New Jersey, North Carolina, Pennsylvania and Texas — where HHS will operate the exchanges. It will continue to expand into other states. The campaign also is launching online and social media communication efforts, which will later include a paid advertising campaign.
HHS Sec. Kathleen Sebelius came under fire last month when House Republicans learned that she had urged private sector companies to support Enroll America. She told a House committee on June 4 that she was doing what other administrations had done before. She pointed to the Clinton administration’s partnerships to encourage enrollment in the Children’s Health Insurance Program and the administration of President George W. Bush working with pharmaceutical firms to have Medicare beneficiaries access prescription drug coverage. Health plans have denied that HHS solicited them for funding.
Media reports last year quoted Aetna Inc. and UnitedHealth Group as readily admitting they gave $100,000 and $50,000, respectively, to Enroll America’s $100 million fund drive. A Bloomberg report on Nov. 29, 2012, said insurers were supporting the work of Enroll America “to make people aware of the law’s benefits and help them enroll in exchanges.”
Enroll America is the brainchild of Ron Pollack, executive director of the health care advocacy group Families USA, who wanted to build an entity dedicated to covering the uninsured. Since its inception in September 2011, Enroll America has been sharing space in Families USA’s Washington D.C., headquarters, but is getting ready to move into its own offices nearby to accommodate a rapidly expanding staff. The group began the year with just eight staff members, but now has more than 40, including a “digital team” that will focus on social media outreach. As its new outreach initiative goes into effect, it intends to add “a couple of hundred” new employees, many of whom will work out of state offices, says outgoing Executive Director Rachel Klein, who is moving to a new role within Families USA.
Seven Questions for Enroll America
This month, HEX paid a visit to Enroll America’s soon-to-be-former office and spoke with Klein to find out how the group intends to reach a population that might never have had health coverage and knows nothing about exchanges, federal premium tax credits or the Affordable Care Act (ACA). In her new position, Klein will focus on the education of navigators, in-person assistors and other groups that will help educate consumers about enrollment opportunities. Here’s what she said.
HEX: Not many people know about the reform law. How do you reach them?
Klein: The people who will benefit most from expanded coverage had never heard of it. That means we have to be very creative because the traditional sources of information are not going to be sufficient for getting the word out. Over the last couple of months, we have hired a digital team, because a huge piece of the outreach effort is going to be social media. That’s where people get their information now, and we need to make sure that we are getting our message out where people will see and hear it.
One thing we learned from the survey work we did last fall is that an enormous number of people, 78%, have not heard about this expanded coverage. We have to reach consumers who have never had access to affordable coverage — and people who haven’t had access to Medicaid because they earn too much — and explain that there will be a subsidy to help them buy coverage. Our role is to educate people who are skeptical about the whole system. We have to explain that the landscape has actually changed, and that there is something new out there. People assume that if they’re not offered coverage from their employer that it is just not available to them, because they either can’t afford it on their own or they may have a pre-existing condition that will prevent them from getting coverage. The very things that make people skeptical about the health insurance system are addressed in the ACA. Conveying that message to people really is our key goal.
HEX: Do you work directly with HHS?
Klein: We are independent, non-partisan and not-for-profit. We don’t receive federal or state funds, but we do work collaboratively with the administration. They will begin their own outreach work soon, but there is a limit to what the government can do. It is important that there is a private sector effort to amplify the message and get it out in more creative ways. We are also partnering with state governments and many other private sector stakeholders.
HEX: Who are your stakeholders?
Klein: We launched with 20 different organizations, and now have more than 60 partners, which include [health insurers, hospital and medical associations and pharmacy groups]. Our partners typically don’t agree on much when it comes to the ACA, but they do agree that whatever coverage is available, people should have access to it. We have been careful to focus our efforts only on outreach and enrollment. We have reached out to groups and others have come to us, but all of them have some connection to the uninsured. The American Academy of Pediatrics, for example, has members who have uninsured patients. Those people will be asking their doctors for information [about the reform law].
HEX: What do health plans want to know about outreach?
Klein: Health plans want to know what the uninsured already know about health coverage and what are the best ways to get them information about their products. Insurers will be marketing their plans, while Enroll America will be engaging consumers about all of the new coverage options and help with the cost of that coverage that is newly available. There is still a lot of uncertainty out there about how far health plans can go in marketing and outreach, and they are thinking creatively about what they can do and how that will connect to the activities of Enroll America, the federal government and state-run marektplaces.
HEX: Are you working with state insurance exchanges?
Klein: Yes, we are working carefully to ensure that our efforts build on rather than duplicate the outreach efforts that states are undertaking. The state-based marketplaces are all working on their outreach campaigns, and are at different stages of that planning. The marketplaces, health plans, and other stakeholders each have an important — but different — role to play in getting information to consumers about their new health coverage options. Insurers will be marketing their products and making sure people know what is available to them, and what they will cover. HHS and states will be educating people about how the marketplaces work. There are a lot of different pieces of the puzzle that I think will fit together to give consumers a clear picture of the new health coverage landscape..
HEX: You’re hiring people in several states. What kind of person do you look for as a state lead?
Klein: We are looking for people who are knowledgeable about the ACA, who already have relationships with a lot of [community] entities, who knows the population we are going to be dealing with, and are able to help craft a very state-specific outreach enrollment program for that state. Reaching out to Latinos in Arizona will be very different than reaching African Americans in Cleveland, and we want to be conscious of that. We are taking a very scientific look at where the uninsured live, who the uninsured are, and we are developing our campaign to be effective at reaching those populations.
HEX: And what happens after open enrollment?
Klein: The first open enrollment runs from Oct. 1 through the end of March 2014. And after that, every open enrollment will run from Oct. 15 to Dec. 7. Our outreach efforts will ramp up between now and Oct. 1, when it will crescendo, and will stay at that level through the end of March. We will scale back between enrollment periods, but we won’t stop activities. People who are eligible for Medicaid can sign up all year long, so won’t stop activities. [After open enrollment], we will evaluate of our activities to figure out how we can make it better…. Who are we reaching and who are we not reaching and what can we do differently to reach them?
For information about the Get Covered America Campaign, visit www.getcoveredamerica.org/pages/press-release-gca-launch.
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