Preparing for Health Exchange Enrollment
The Affordable Care Act (ACA) needs outreach workers, and trainers and experts to support enrollment efforts for the new Exchange marketplaces. A working knowledge of public administration—and related practice skills—will be useful.
Efforts are being made to deploy large numbers of front-line, local outreach representatives, to include “navigators”, community health workers, librarians, and those with many other skills, along with a network of call-center agents, to support initial enrollment efforts.
A formal navigator program is moving forward, and community health workers are being brought in as participants (as described at www.enrollamerica.org and www.healthcare.gov ). Librarians across the country are also preparing to answer questions.
And a large call-center development with over 9,000 agents to be added is under way (Robert Pear, “U.S. Unveils Health Care Web Site and Call Center”, www.nytimes.com , June 24, 2013). These efforts are to be supplemented by many other supporters of ACA objectives through a variety of individuals and organizations—to get the word out and spur individuals to sign up (as noted by Jennifer Haberkorn in “Blue Cross, Walgreens team for Obamacare campaign”, www.politico.com , July 11, 2013).
There are opportunities for those with education and experience in public administration to become involved—as outreach “helpers” and as trainers and consultants for these workers.
The objective is to reach out to uninsured individuals who may be eligible to qualify for coverage through the Exchanges (with subsidies potentially available). In some states, there may also be an opportunity for individuals with limited income to enroll in the expanded Medicaid program. These uninsured individuals need to be linked up with the new sign-up opportunities, given information about the choices, and supported in completing the application process.
This outreach effort can only succeed if the ACA helpers are prepared for the job. A network of trainers is needed to “help the helpers” get ready to reach out to individuals in the community—and to serve as backup consultants when there are questions to be answered. The same backup is needed for the call center agents.
Without such supporters, the front-line helpers are likely to give out inaccurate advice, leading to mutual frustration by all involved, and potentially threatening implementation of the ACA.
The present objective of the Department of Health and Human Services (HHS) is to enroll 7 million eligible persons during October to December 2013. In order for the plan to work at least 2.7 million of these are supposed to be young adults. (Zeke J. Miller, “And Now, the Selling of Obamacare”, www.time.com , June 20, 2013.)
This activity will require trained and committed outreach workers, and a network of backup trainers and consultants.
Many of those participating in the outreach efforts will not understand all of the ins-and-outs of eligibility, which will be complex and will vary with available insurance options in each state. Therefore, care must be taken to set up workable procedures.
Large error and rejection rates by applicants may possibly result in an enrollment backlash, which could damage ACA reputation. Follow-up will be difficult in many cases, if navigators need to link up multiple times with applicants to work problems.
Two major issues on the table are “will the Exchanges and state agencies be ready?” and, if so, “will people enroll?” Almost for sure, some people will enroll throughout the last quarter of 2013, and be ready to start coverage on January 1, 2014. The major unknowns are who will enroll and how many will enroll.
This is installment #4 of a continuing series of blog postings dedicated to the tracking of implementation efforts for the ACA and the administrative insights that may be gained.
OTHER RELATED POSTS:
Putting the Affordable Care Act into Action
Federal Agencies Struggle to Implement ACA
The ACA Goes Public