The Doctors Care Health Access Team recently had the privilege to visit Washington D.C. for the 2016 State of Enrollment conference. Organized by Enroll America, the nation’s leading health care enrollment coalition, this three-day conference brought together leaders and health coverage navigators from across the country to reflect on the progress that has been made during the first three years of the Affordable Care Act (ACA) and to look ahead to the challenges and opportunities that remain.
The conference agenda was packed with three plenary sessions that included leaders like U.S. Department of Health and Human Services Secretary Sylvia Burwell, Congressman Joaquin Castro, and White House Chief of Staff Denis McDonough. We also took part in interactive workshops, breakout sessions on best practices for getting and keeping individuals enrolled, and informative panel discussions with health care leaders. It was an exhausting three days of learning and sharing. We received many important insights and takeaways and our team returned with a clear sense of how we can improve our program for the upcoming year.
Representatives came from all over the country. We met health coverage navigators from states that did not expand Medicaid, states on the Federal Exchange, states with only one health insurance company on the exchange, and states, like Colorado, that embraced Medicaid expansion and established their own exchange. It was remarkable that no matter where the representatives were from or their political environment, folks everywhere were doing incredible work to reduce the number of uninsured in their area.
States without Medicaid expansion (19 total) still see a large population of individuals who have no health coverage options. Health Coverage Navigators report this is a significant challenge with a continued need for safety net services in these states. To raise awareness about health coverage, some organizations have established innovative partnerships with local institutions like HUD, food banks, and even the utility company. A nationwide survey conducted to better understand continuing barriers to increasing enrollments found that a large proportion of individuals who buy insurance on the exchange during open enrollment stop paying their premiums during the year but then return to the exchange to shop again when open enrollment begins. A fair number of the remaining uninsured actually visit the exchange to shop but decide not to enroll.
The work of healthcare reform is not complete. The ACA aimed to expand coverage and bend the cost curve but even Secretary Burwell acknowledged that more needs to be done to place downward pressure on costs, increase access to care, and improve our population’s health outcomes. Medicaid expansion in every state is another critical aim that has not been achieved.
We left the conference with a clear vision of our goals for the Doctors Care Connection to Coverage Program:
• Establish a more robust protocol for following up with and engaging clients after open enrollment. It is clear that the clients we assist during open enrollment need additional Health Insurance Literacy services throughout the year to ensure they stay enrolled and access care.
• Enhance enrollment assistance appointments to set the stage for an ongoing relationship that includes a follow-up appointment and communication throughout the year.
• Seek to create new partnerships with county law enforcement services to outreach to justice-involved individuals.
• Implement a client feedback survey after each appointment to help improve our services.
• Partner with Denver Health outreach services and re-engage with our hospital partners to assist with enrolling the uninsured.
Of course, no visit to Washington, D.C. is complete without seeing the sites! In fact, for one of our team members, this was her first visit to our nation’s capital so we did our best to take it all in. We are grateful to Connect for Health Colorado for providing this wonderful opportunity to learn and be encouraged by the great work being done across the country to improve access to coverage and care.
