Your State Needs You

By Guest Blogger

Is your state preparing for the grand opening of the new health insurance exchanges next year? Open enrollment will begin in less than 377 days, and most of the newly eligible don’t know about the new coverage options or how to enroll.

For many Americans, this will be the first time they apply for financial assistance, shop for a health plan, and use coverage to obtain health care services. It will be essential to ensure that consumers at all income levels learn about the new coverage options, know that they can enroll in many different ways (online, by phone, in person, or through a traditional mail-in application), and understand that help is available to guide them through the enrollment process.

No matter how easy we strive to make the enrollment process for health coverage, there will still be a critical need for states and the new health insurance exchanges to offer consumer assistance from a wide range of individuals and organizations. Without a diverse network of well-trained entities available to help, we will come nowhere near our goals for enrollment. Our latest issue brief on the importance of in-person assistance identifies several ways that stakeholders can help states reach uninsured consumers in their communities and get them enrolled before the end of the initial open enrollment period (October 1, 2013 through March 31, 2014).

Local stakeholders, such as small businesses, consumer groups, faith-based organizations, chambers of commerce, insurance brokers, unions, and other community-based organizations, have the ability to reach people in ways that government efforts simply cannot, and many have longstanding relationships with people who are uninsured. Some ways that organizations can help people enroll include the following:

  • Providing in-person assistance with the enrollment process
  • Participating in the navigator program
  • Serving as a door to their state’s “no wrong door” enrollment system
  • Partnering with organizations that are providing enrollment assistance
  • Spreading the word about the new coverage options

Read our new publication Bridging the Enrollment Gap: The Importance of Providing In-Person Assistance to learn more.

HHS has also recently made it even easier for states to design consumer assistance programs that will meet increased need in 2013 and 2014, during the first two open enrollment periods. In the recently finalized Exchange Blueprint (the application for a state-based or state-federal partnership exchange) HHS outlined a new optional in-person assistance program that is distinct from – and in addition to – the navigator program. Unlike the navigator program, which is subject to federal funding restrictions (federal funds cannot be used to provide grants to navigators), the in-person assister program can be set up and operated with the help of federal establishment grant funds. Navigators are also subject to federal regulations that specify a minimum set of duties and competencies. See Georgetown University’s Center for Children and Families series of briefs about navigators to learn more. While we are waiting for additional guidance from HHS to better understand the new in-person assister program and the various roles stakeholders can play, we think it is imperative that states and stakeholders alike begin to think creatively about how to ensure that there is adequate in-person assistance for all the different kinds of people who will need to enroll in coverage starting next year.


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