Help! I Need Somebody: How Enrollment Assistance under the ACA Will Make All the Difference

William Tomasko
Enroll America

enroll_americaStart your timer. Count down the days. Open enrollment is coming. On October 1, consumers will be able to start signing up for the new health coverage options under the Affordable Care Act (ACA)—and there will be new opportunities for them to get help finding quality, affordable plans.

Our organization, Enroll America, is a nonprofit, non-partisan 501(c)3 dedicated to spreading the word about Americans’ new health coverage options. Working with our broad array of partners, we’re helping consumers get the facts about how they can get covered and engaging the entire health care community as we all mobilize for enrollment.

Out of those who reported having an unmet need for mental health care in 2011, nearly two-thirds said they went without care because they couldn’t afford it or because their health insurance either wouldn’t cover it at all or insufficiently covered it, according to data from the Substance Abuse and Mental Health Services Administration.

And around 30% of those who will soon be eligible for financial help through health insurance marketplaces or from expanded Medicaid have a mental illness or a substance use disorder. In total, around 11 million in need of mental health and substance use disorder care could benefit from newly enrolling in coverage this fall.

Getting these individuals enrolled will take one of the biggest outreach and public education efforts ever undertaken in the history of public health coverage programs. Why? Our research reveals that 78% of the uninsured don’t know (yet) about the coming coverage options. Our findings point to some of the most important messages to use to compel people to enroll, and the effective ways to reach them.

Messages

The uninsured want the facts about the new coverage coming. Messages that use the following four facts reach an overwhelming 89% of the uninsured:

  1. All plans have to cover certain benefits, like doctor visits, hospital care, emergency room care, prescription drugs, and mental health and substance use disorder services.
  2. Many individuals will qualify for new financial help with the cost of coverage.
  3. Plans can no longer deny coverage due to a preexisting condition.
  4. All plans have to show the costs and what is covered in simple language with no fine print.

Reaching the Uninsured: The Importance of Help

Once someone has heard these messages and is ready to enroll, we found that in-person enrollment assistance will be absolutely crucial. Three out of four of the soon-to-be-eligible say they want in-person assistance getting enrolled. Many of them have never had health insurance before, and they’ll need to know how to apply and how to choose a health plan that works for them. Fortunately, while enrollment assistance options will vary from state to state, consumers in every state will be able to work with trained assisters who can answer their questions and help them get enrolled.

Open enrollment will be a learning experience for all who are involved, and consumer assistance will be a huge opportunity to help everyone to take full advantage of the new options under the law. In-person help can make all the difference to walk people through their coverage choices and turn the promise of affordable care into a concrete reality.

Who would you trust the most to give you the facts on how to enroll in health coverage?

How have you been hearing about the new choices and coverage available starting October 1?

How can outreach be as effective as possible?

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