Transcript Slides from Enroll America

The Road to Enrollment:
Connecting Millions of Americans to
Coverage
Mental Health America Webinar
February 28, 2013
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Delivering on the promise of
affordable health coverage for
millions of Americans . . .
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. . . starts now.
only 215 days
until October 1, 2013.
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Enroll America
Our Mission
Ensure that all Americans get
enrolled – and stay enrolled –
in health coverage.
We will continue:
• Building coalitions
• Sharing best practices
Coming soon: a major enrollment campaign, using
cutting-edge engagement strategies
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How will people APPLY for
coverage?
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Online? By phone? On paper?
Available in the right languages?
Written in plain language?
Accessible for people with
disabilities?
What SYSTEMS will need to be
developed to make it possible?
• Consumer-friendly “front end”
• “Back end” systems that are
coordinated between Medicaid,
the Exchange, CHIP, other
programs
• Connections with data that can
help prove eligibility
What ASSISTANCE will they
need?
• Understanding the application
and eligibility process
• Counseling on tax credit
decisions
• Help choosing a plan and
learning how to use it
How can people KEEP coverage
once they’ve got it?
• Data-driven renewal
• No need to return forms
• Opportunities to update
information and change
coverage as circumstances
change
Sampling of Partners
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Health Coverage in 2014
Coverage Options for Adults without Medicare
or Employer-Based Coverage
Income as a percent of the federal poverty level
0
133
Medicaid
400+
Exchange
(“Marketplace”) with
Tax Credits
Exchange or
Private Plan
An Opportunity for a Complete Continuum of Coverage
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The 2014 Enrollment Opportunity
Millions
Enroll at least 15 million people in new coverage options
}
7 million in Exchange coverage
}
8 million in Medicaid or CHIP
Source: February 2013 CBO estimates
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Enrollment isn’t a snap
Take-up in optional public benefit programs
Program
Children’s Medicaid/CHIP, national average, 2009
Medicare low-income subsidy, 2009*
Percent of Eligible People
Enrolled
84.8%
40%
Unemployment benefits
72-83%
Earned income tax credit
80-86%
SNAP (food stamps)
54-71%
* Does not include populations automatically enrolled in the low-income subsidy.
Limited Public Awareness
83%
The majority of uninsured Americans
who may be Medicaid eligible don’t
know the health reform law will help
them.
75%
Three out of four of the newly eligible
want in-person assistance to learn
about and enroll in coverage.
Enroll America Research, November 2012
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Two-thirds of
the uninsured live
in 12 states
Where are
the
Uninsured?
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Arizona
California
Florida
Georgia
Illinois
Michigan
New Jersey
New York
North Carolina
Ohio
Pennsylvania
Texas
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Demographic Profile of the Uninsured
(Nonelderly Adults, Ages 18-64)
Percent of
Uninsured
Uninsured
Rate
White (non-Hispanic)
45%
13%
Black (non-Hispanic)
15%
21%
Hispanic
32%
32%
Asian/Pacific Islander
5%
18%
American Indian/Alaska Native
1%
27%
Two or More Races
2%
15%
Race/Ethnicity
62%
47% 53%
Live in Families
with at least One
Full Time Worker
Source: Kaiser Commission on Medicaid and the Uninsured, October 2012
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Building an Effective Campaign
Paid advertising on
TV, radio, online,
and in print media
Grassroots
field efforts
Earned media events
and Activities in
communities to
magnify messaging
Paid advertising
on TV, radio
online, and in
print media
National and
local surrogates
Data,
Analytics,
Microtargeting
Constituency
engagement
Creative use of
social media
Education & engagement
through partner entities with
direct reach to target
populations
Strategic
Partnerships
Enrollment
assistance by
trusted
community
sources
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Grounded in Research
1. The most effective messages
to reach target groups
2. The best messengers for
these communications
3. The best ways to deliver
these messages (e.g.
television, radio, social media,
etc.)?
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For many, looking for health coverage is a
negative experience.
If you had to look for health insurance now,
what feelings do you think you would have?
How they want to feel is confident,
informed, secure, satisfied, and in
control.
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Segmentation
Unnecessary & Uninterested – 24%
• Skeptical Young Men
Reluctant, but Reachable – 21%
• Young, Diverse Families
Connected, Low-Income Women – 11%
• Medicaid, CHIP, SNAP connection
Desperate & Believing – 13%
• Sick, Poor, Least Educated
Insured & At-Risk – 11%
• Young, Under 250% FPL
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Key Findings
Almost all (91%) believe health insurance is necessary or
very important.
Cost and affordability are the biggest barriers.
Financial & health security are the biggest motivators.
Deep skepticism & confusion among consumers.
Four Key Messages to Reach Most Uninsured
All insurance plans will have
to cover doctor visits,
hospitalizations, maternity
care, emergency room case,
and prescriptions.
You might be able to get
financial help to pay for a
health insurance plan.
If you have a pre-existing
condition, insurance plans
cannot deny you coverage.
All insurance plans will have
to show the costs and what
is covered in simple
language with no fine print.
How will the enrollment process work?
or
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Key State Decisions
Medicaid
Whether to expand to 138% FPL
Exchanges
Whether to have a state, partnership, or
federal exchange
When to expand to 138% FPL
How long to maintain an expansion
NOT allowed to expand incrementally
NOT allowed to reduce adult eligibility
before 2014 or child eligibility before 2019
How the state will provide enrollment
assistance
How the state will coordinate eligibility
between the exchange, Medicaid, and
CHIP
NOT whether an exchange and premium
tax credits will be available to families
What kind of exchange are states likely to have?
As of February 19, 2013
947,600*
M
176,800
M
565,400*
M
278,800*
74,400
M
55,300* M
492,800*
104,400
97,200
229,600
588,000
*
7.2 million*
M
393,300*
M
1.2 million
M
M
553,600
411,100*
1.2
million
1.9
Million*
364,800
851,100
M
635,200
2.6 million*
1.4 million
M
120,500* M
340,600* M
1.3 million
93,700* M
M
1.1 million
869,500
504,200*
M
M
146,700 M
280,700* M
M
329,500
710,300*
M
126,500
758,500* M
1.6 million
901,000
1.9
million
661,800
6.1 million
895,800
Alaska:
Hawaii:
125,900
99,200* M
Note: Numbers provided are non-elderly uninsured, based on the Census Bureau’s Current Population Survey (2011-2012 twoyear merge). Asterisked states have obtained HHS’s conditional approval for their state-based or partnership exchange.
Federally
Facilitated
Exchange
Partnership
exchange
State-based
exchange
M = Governor
supports
Medicaid
expansion/
expansion likely
Requirements for ALL states
A Single, Streamlined Application
• One application for all health coverage programs
• Available in online, phone, and paper
Use Modified Adjusted Gross Income/No Income Disregards
Eliminate Asset Tests
Eliminate In-Person Interview Requirements
Use Electronic Verification to the Greatest Extent Possible
Regardless
of Medicaid
expansion!
Simpler process…
but people will still need help
What Kind?
• Figuring out if they qualify for financial help (55%)
• Finding the best plan for them (52%)
From Whom?
• Someone from your state whose job it is to help people with these new options (45%)
• Family member (37%), your doctor or nurse (36%), someone from a health insurance company
(35%)
• Which family member? Spouse (42%) or mom (20%)
How?
• In-person (75%), telephone (33%), email (20%), online chat (9%)
Where?
• Insurance agent or broker’s office (29%), family member or friend’s home (27%), clinic or
doctor’s office (22%), Medicaid office (21%).
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Outstanding Questions about Assistance
• Scope of navigator
programs?
• Which states will design
separate in-person
assistance programs?
• What role will Certified
Application Counselors
play?
• How will in-person
assistance be coordinated
with phone and online
assistance options?
Who will provide
assistance?
Certified
Application
Counselors
In-Person
Assistance
Programs*
Navigators
*Option not available in federally
facilitated exchange states
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Working together: We
all play a role in a
successful enrollment
effort
www.enrollamerica.org
More Information On:
• Best practices in outreach
and enrollment
• Exchange branding
research
• Public opinion polling
• Statewide marketing and
outreach plans
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Questions?
Jenny Sullivan
Director, Best Practices Institute
Enroll America
[email protected]
202-879-0286