Keys to a Successful Open Enrollment Period
October 29, 2018 | By Liz Hagan
We are only hours away from the beginning of the sixth open enrollment period for states using healthcare.gov, and this year is not without its challenges. A broad array of stakeholders—community partners, assisters, community health workers, health centers, friends and family of people in need of health care, and others—all have roles to play to make sure people understand their coverage options and can make informed decisions about enrolling in and using their health coverage. These consumer needs will never go away, even if outreach and enrollment efforts change from year to year.
Where We Are
As enrollment assisters and other stakeholders engaged in outreach and enrollment since the first open enrollment period for the Affordable Care Act (ACA) know, this work has always come with some level of uncertainty and a fair share of challenges. But if past is prologue, we know that enrollment assisters and others are up to the task and are dedicated and committed to helping people in their community enroll in coverage and access the care they need.
Reaching Goals and Achieving Success
While many remain committed throughout the country to help consumers navigate this new environment, which includes severe budget reductions and a lack of general support for consumer assistance, there are significant challenges that assisters and other stakeholders are planning around.
Whether you’re a Navigator, certified application counselor (CAC), community partner, health center, or friend of someone in need of health care we know that keys to success include:
Understand the questions people will ask: Consumers will have questions about the marketplace, how the plan they are currently enrolled is in changing, useful comparisons for any new marketplace coverage options and costs against this Administration’s latest options (such as association health plans and short-term plans), which are similar to plans pre-ACA. Consumers will need to make complex decisions such as whether they should still enroll in coverage with the elimination of the fine for not having coverage, new plan costs, and more!
Ensure consumers know deadlines and when to enroll: There are still limitations with consumer knowledge about the ACA including knowing when they can enroll in coverage and what the deadlines are, so it remains critical to spread the word among partners and consumers about the timeframes. Note that some state-based marketplaces have different open enrollment dates and deadlines than healthcare.gov.
Make the most of the limited time for open enrollment: Healthcare.gov only has a six week open enrollment period. Unfortunately, part of that time is over the Thanksgiving holiday and the midterm elections. Enrollment stakeholders still need to prioritize enrollment itself as the main goal over this timeframe, and to make sure all education and outreach is done prior, and after, open enrollment. This may require adjusting normal staff hours to accommodate times of high demand.
Fortunately, a few tested resources remain available to help in this space. Some of our favorites include The Center of Budget and Policy Priorities Health Reform Beyond the Basics webinar series, Young Invincible’s Get Covered Coalition and OE6 Toolkit, Community Catalyst Outreach Hub, and In the Loop.
Enrolling consumers in coverage during open enrollment is just one small part of health coverage and the enrollment and navigation landscape. Help with navigating costs and coverage is just one component of this work. Assisting individuals with upstream interventions, and working to improve health equity and address social determinants of health, such as health and housing, requires year-round interventions to improve access to health care and, more importantly, the health and wellbeing of individuals.
It is important to meet the needs of the whole person going forward. As we plan for what must take place beyond open enrollment: access to primary care, health and housing, access to behavioral health care, tackling the opioid crisis, as well as addressing other social determinants of health, are now mission-critical. If you would like to work with Transform Health on open enrollment, navigation, or post-enrollment strategy, or have enrollment policy or programmatic questions, please contact Heather Bates at firstname.lastname@example.org or Liz Hagan at email@example.com.