This column originally appeared in Morning Consult.
When I started my role as President of Enroll America in January of 2013, there were a lot of questions and skepticism as to what we could achieve. We were in uncharted waters and facing strong headwinds. Nobody had tried to use campaign tactics in a public enrollment effort of this scale before. Awareness of the new health insurance options under the Affordable Care Act was extremely low among the uninsured. And we didn’t know if we’d have the resources to reach the millions of people who needed the facts about how to enroll in coverage.
To overcome these challenges and meet the ambitious goals ahead of us, we built an incredible team, placing heavy emphasis on staff on the ground doing direct consumer outreach. Working together with the vast coalition of organizations in this effort, we’ve now seen 11.7 million people enrolled in Marketplace coverage, and more than 10.7 million enrolled in Medicaid. This is an achievement beyond what any of us imagined, especially given the rocky start of Healthcare.gov and uncertainty surrounding which states would choose to expand Medicaid.
Fewer than eighteen months after the launch of the Health Insurance Marketplaces, we have made enormous strides. The uninsured rate is at a historic low, and the enrollment coalition has never been stronger. Most importantly, millions of Americans have discovered the financial security and peace of mind that comes with having health coverage, building a strong foundation for a sustainable and competitive Marketplace.
What’s more, the tactics we pioneered in our consumer-facing Get Covered America campaign and tested through two enrollment cycles have proven to be incredibly successful. An analysis of enrollment rates by ZIP code (based on eligibility estimates from the Kaiser Family Foundation) shows that states and local areas where Get Covered America was active consistently saw higher enrollment rates during both the first and second open enrollment periods than areas that did not. In fact, an independent evaluation by Mathematica Policy Research found that the Get Covered America model “uses data-driven, campaign style methods to increase enrollment […] at a level of scope, rigor, and sophistication never seen, to our knowledge, in a public coverage program outreach effort.”
I can honestly say that we’ve achieved much more than I could have dreamed during those early days. So where do we go from here?
The next phase of our organization is about making our success permanent by embedding the enrollment tactics we’ve learned into local organizations that are beyond the reach of the political back and forth in Washington. We envision a day when our organization is unnecessary because we’ve made enrollment outreach and support an institutional reality in communities across the country. In the coming years, as health coverage enrollment becomes a way of life and the number of uninsured continues to decrease, we’ll begin passing the baton on to local organizations and leaders who will continue to do this work for years and decades to come.
Moving forward, we will maintain a staff of more than 100 people who will work with our more than 4,600 partners in all 50 states to reach consumers, create cutting-edge tools, analyze data, inform policy, and share best practices in service of our mission. We’ll have an on-the-ground presence with staff working alongside partners and volunteers to support outreach and enrollment work in a total of 11 states: Arizona, California, Colorado, Florida, Georgia, Michigan, North Carolina, Ohio, Pennsylvania, Tennessee, and Texas.
We’ll be offering a comprehensive new suite of training and support services, ranging from in-person trainings on consumer outreach and how to use sophisticated data targeting and digital outreach tools, to tailored market and demographic analyses for organizations and businesses doing enrollment work. We’ll also be continuing to improve and grow the innovative set of tools we’ve created like the Get Covered Connector, which is already being used in 28 states to allow consumers to easily schedule appointments online with in-person assisters. And in June, we’ll be holding the second annual State of Enrollment conference, where the enrollment community will come together to talk about what we’ve learned, and how to be successful in future open enrollment periods.
Looking back on all we’ve achieved during the start-up phase of ACA implementation, I can say that I’m proud of the work we’ve done, but I’m not yet satisfied. Millions of Americans who could enroll through the Marketplaces or Medicaid remain uninsured. Now we face a new reality and a new challenge: how to make health coverage enrollment a permanent part of the fabric of American communities for years to come.
The future of Enroll America and the health coverage enrollment effort is incredibly bright. The groundwork for permanent success has been laid. We’re confident that with our thousands of local partners — from municipal governments to faith institutions to hospitals and community organizations — we can build on what we’ve learned to maximize the number of Americans who enroll in and retain quality health coverage.
Anne Filipic is the President of Enroll America.