Enrollment assisters an essential piece of ACA’s success, survey shows


Navigator Leon McIntosh helps New Yorker Anna enroll

We all know finding the right health insurance plan can be complicated and overwhelming – even with the launch of the insurance marketplaces offering one-stop shopping under the ACA. One of the most exciting features of the ACA is the establishment of assister programs to help people enroll (e.g. Navigators and Certified Application Counselors). A new survey from Kaiser Family Foundation shows just how effective these groups were during the first open enrollment period.

According to the survey, administered to directors of assister programs around the country:

28,000 assisters helped 10.6 million people apply for coverage and financial assistance.

States with State-based Marketplaces, like New York, had a much higher ratio of assisters to uninsured and helped two times as many people relative to the uninsured population when compared to states with a Federally-facilitated Marketplace. Our own NY State of Health‘s recent enrollment report shows that 643 Navigators and nearly 4,000 Certified Application Counselors helped over 413,000 New Yorkers enroll in coverage. That’s nearly half of enrollees.

Most consumers who sought help applying for coverage were uninsured and had limited health insurance literacy.

The vast majority of programs reported that consumers seeking help had a limited understanding of the ACA and struggled with basic health insurance terms, like “deductible.” As a result, assistance took time – between one to two hours in most cases.

Nearly all assister programs have been “re-contacted” by consumers with post-enrollment problems, including questions about how coverage works.

Questions from consumers don’t stop at enrollment. However, assister programs are not trained on post-enrollment issues, and in many cases don’t have funding that allows them to provide this type of assistance. Instead, the ACA established Consumer Assistance Programs (CAPs) to provide these services, but these programs haven’t received federal funding since 2012. Luckily, New York legislators recently approved $2.5 million in the 2014-2015 budget for the State’s CAP, Community Health Advocates (CHA). Thanks to the funding, CHA will be able to provide more robust hotline and in-person services through community-based organizations in the coming months.


Guest post from Maryanne Tomazic, Raising Women’s Voices

New survey data released this month by the Kaiser Family Foundation includes many important findings on women and health care.

The national survey of 3,105 women took place in late 2013, before the end of the first open enrollment period of the new health insurance marketplaces. It showed that low income women and women of color experience high rates of being uninsured.  While many women have enrolled in plans via the marketplaces (NY State of Health enrolled 189,888 women into qualified health plans as of the end of April!), others still cannot afford the cost of the qualified health plans. Still others live in states that, unlike NY, have not expanded Medicaid.

The survey also showed that cost is often a barrier to accessing health care services. Most women reported delaying or forgoing care because of cost: Two thirds of uninsured women, 35% of women with Medicaid, and 16% of women with private insurance. Other barriers to healthcare included being unable to take time off of work, not being able to get child care, and lack of transportation.

These survey results show that even though the Affordable Care Act has expanded and continues to expand coverage options and make insurance more affordable, steps are still needed to make sure women are able to get and use the care they need.

For the full report, click here.

Final Numbers for first open enrollment period

Yesterday, HHS announced that over eight million Americans enrolled in health insurance between October 1, 2013 and March 31, 2014. That’s over a million more than the original goal for that period (seven million) and over two million more than the revised goal. As recently as the middle of March, some media outlets predicted that enrollments would fall short of this goal. But, enrollments surged during the last month of open enrollment, with the administration reporting that nearly 3.8 million people selected a Marketplace plan in the final month.

Note, too, that both the federal government and New York’s own Marketplace, NY State of Health, issued a 15-day extension period for those who ran into barriers completing their applications during this time. So, the final count of “open enrollment” sign-ups will be even higher. In New York alone, nearly 100,000 people enrolled between April 1 and April 15.

We’re looking forward to the next report of detailed demographics data from NY State of Health, something like the December Enrollment Report they released in early January. In the meantime, the HHS report gives us a taste:

  • New York ranks 4th in the nation in terms of sheer number of Marketplace enrollments, with 370,451 enrollments in private Qualified Health Plans (QHPs). We’re behind only California, Florida, and Texas.
  • Just over half of enrollees were women.
  • About 1/3 of enrollees were young adults between 18 and 34.
  • Over half of enrollees selected a Silver-level plan and over 80% selected a Silver plan or above. 
  • Nearly 3 out of 4 enrollees received financial assistance (e.g. tax credits).
  • States also reported the difference between March 2014 enrollment and Pre-ACA Average Medicaid and CHIP (children’s health insurance) enrollment (July-September 2013). In New York, about 343,835 additional New Yorkers enrolled in Medicaid or our Child Health Plus program during the first open enrollment period.

The federal report also includes enrollment by race/ethnicity for the federal marketplace. We don’t have this data for New York…yet. Hopefully, the next NY State of Health enrollment report will include it.



Optimized-04-16-14 Crowd Listens to Amy's Stories
  Volunteers gather to celebrate success of Get Covered New York


Guest post: Linda Ricci, Co-founder Get Covered New York and MA Student in Health Advocacy, Sarah Lawrence College

The first open enrollment deadline for NY State of Health had barely passed when Get Covered New York members, friends and volunteers got together to mark the stunningly successful enrollment numbers, and more. Get Covered New York (GCNY) is a grassroots public awareness campaign that connects New Yorkers to affordable health coverage. On April 16, GCNY held a celebration, hosted by co-founder Kate Linker, to share the good news about the more than 960,000 enrolled on NY State of Health – and to thank the many volunteers who helped make it happen.

In her remarks, GCNY co-founder, Lois Uttley of Raising Women’s Voices, recalled that two organizations came together at the start, with HCFANY’s health care expertise and the experience in organizing volunteers that Greater NYC for Change contributed. Kate Linker recalled the first group meeting that took place in her loft, which included HCFANY members Elisabeth Benjamin of the Community Service Society, Mark Hannay of Metro NY Health Care for All Campaign and Heidi Siegfried of Center for Independence of the Disabled-NY and New Yorkers for Accessible Health Coverage. Their efforts resulted in volunteer participation beyond anything these collaborators could have hoped for.

Starting last summer, GCNY volunteers went out into the field and made calls to spread the word to uninsured people that new health insurance options are available on NY State of Health. These tireless volunteers canvassed at street fairs in Harlem, including a Great Day in Harlem, and at health fairs, collaborating with the Bronx Community Health Network and others. As the weather got cooler, volunteers took to soup kitchens like the one at the Holy Apostles Church in Chelsea and to making presentations at PTAs, including at PS 69 in the Bronx. They asked uninsured people for their contact data for follow up and directed them to local navigators. From February on, GCNY organized weekly phone banks where volunteers made calls to the uninsured with reminders to sign up, and again encouraged them to call a navigator.

The success of this approach can be measured in numbers and stories. In the past year, Get Covered New York:

  • Engaged 120 volunteers,
  • Organized 80 events,
  • Made 1500 calls during phone banks, and
  • Urged more than 4,000 uninsured people to sign up!

It was enormously satisfying to hear the stories of those who got their health insurance prompted by the work of GCNY. Amy Zarin, a fellow with Raising Women’s Voices, told moving stories. She played an audio recording of her conversation with Kiara*, a part-time retail worker.

Amy recounted Kiara telling her “Get Covered New York, whatever you have been doing, keep doing what you do!” Kiara continued, “You never know who you will meet or what impact you can have on individuals in the community. We need you guys! We seriously need you guys!”

GCNY plans to keep meeting these needs by continuing outreach to those eligible for Medicaid, Child Health Plus and small businesses who can sign up all year long.  And other individuals who need insurance can apply in a special enrollment period during the year if they have experienced life-changing events including marriage, the birth of a child, or the loss of a job.

After taking a breather to regroup after open enrollment, volunteers will be out there again to, in the words of Kiara, keep doing what they do.

*Name changed to protect privacy