Effective Outreach is Key to Enrolling Americans in Health Coverage

By Ani Fete

How important is outreach to ensure that as many Americans as possible enroll in health coverage in 2014?  Extremely important. The Congressional Budget Office estimated that as many as 32 million Americans will gain coverage through the new state health insurance exchanges and the Medicaid expansion, but a new Harvard study suggests that this number is highly dependent on the amount of outreach done to encourage enrollment.

The new study focused exclusively on the number of people who could be eligible for Medicaid, and the authors found that the number of enrollees could vary dramatically. The actual number of people estimated to enroll in Medicaid by 2019 (after the expansion will have been in place for five years) could fall anywhere from 8.5 million to 22.4 million. Originally, the Congressional Budget Office estimated that 16 million would enroll in Medicaid by 2019, an estimate squarely in the middle of the range suggested in this new study. The authors suggest that while methodological factors, such as which data set is used to determine eligibility under the new Medicaid guidelines in the Affordable Care Act, play a role in this variance, policy factors are also a major contributor, particularly the participation rate among newly eligible people who are uninsured. “If states can encourage greater participation, then our higher estimates may be attainable,” the study asserts (emphasis added).

That “if” is very important. It’s no secret that states and the federal government face significant fiscal pressures in these difficult budget times. Enrollment outreach efforts will compete with many other demands on already limited resources. But without a concerted, well-planned, well-executed outreach strategy, millions of uninsured Americans will continue to go without health coverage and needed health care.

Past experiences in enrollment outreach (such as with the Children’s Health Insurance Program (CHIP) and Medicare Part D, not to mention more recent experience with the Pre-Existing Condition Insurance Plans) tell us that the importance of effective outreach cannot be overestimated. Furthermore, effective outreach requires both financial and human resources, and it is most successfully driven by collaboration across government, nonprofit, and corporate sectors. The most recent Census Bureau report showed that nearly 50 million Americans were uninsured in 2010. An effective outreach strategy is critical to ensuring that every one of them knows how and where to enroll in the health coverage that will be available to them in 2014. 

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