The Affordable Care Act was designed to bring together public, private, and non-profit sector stakeholders under the shared goal of making health coverage affordable for all Americans and reducing the number of Americans who are uninsured. But working with for-profit companies can raise complicated questions for non-profit organizations like Enroll America, who are committed to operating in the best interest of consumers. Insurance companies, hospitals, web-based enrollment entities, and other for-profit companies in the healthcare sector can all make important contributions to the success of the enrollment effort – but how can non-profit organizations best work together as a part of this diverse coalition, as the law intended, while ensuring consumers can feel confident their interests always remain our top priority?
One example that offers interesting lessons for those considering these issues is Enroll America’s ongoing work with insurance agents and brokers. When we first began our enrollment outreach, there were some understandable concerns in the enrollment community about working closely with agents and brokers, and whether they could provide the sort of unbiased advice that consumers need when they are starting the enrollment process. At the very start of the first Affordable Care Act open enrollment period, we did see a few fly-by-night operators that attempted to confuse consumers about their enrollment options.
Of course, those opportunistic bad actors weren’t representative of the thousands of reputable agents and brokers who have been offering skilled enrollment assistance for years in communities across the country. As our hundreds of staff and volunteers on the ground in our 11 Get Covered America campaign states worked with the local enrollment coalitions to coordinate efforts, they found that the best agents and brokers had unique insights and skills to offer to the enrollment community, particularly given the complexities associated with understanding and comparing the plans available through the marketplace. Agents and brokers are experts in this aspect of enrollment, which assisters often find to be one of the most challenging part of getting consumers through the process.
The truth is that even with the thousands of dedicated and skilled navigators, CACs, and other assisters across the country, there simply aren’t enough assisters to fully answer the demand for in-person help with the enrollment process. By the time the April deadline for enrollment approached last year, we needed every hand on deck to deal with the long lines of consumers that stretched around enrollment events across the country. With appropriate safeguards in place, working with reliable brokers and agents who could provide the in-person assistance that consumers need just made sense. In the end, many consumers and non-profit organizations were very pleased by the role that brokers and agents played in the final enrollment surge, and this year, we’re working together even more closely and efficiently.
So what makes these partnerships successful, and what should non-profit organizations be thinking about as they decide whether and how to work with for-profit organizations?
First, our staff on the ground carefully vet new partner organizations – both non-profit and private – before we begin working with them, and we share information and set clear expectations from the beginning.
Second, when it makes sense, we establish written agreements about our expectations. In this case, we ask all the brokers and agents we work with to sign a pledge committing to common-sense protections for consumers, including giving consumers information about all of the options available to them (including Medicaid), and never using consumer information from our enrollment events for commercial purposes.
Third, we think carefully and specifically about what kinds of joint activities will be beneficial to both groups. In this instance, the enrollment coalition is bolstered by the addition of many skilled assisters who can provide consumers at enrollment events – and those scheduling appointments on our Get Covered Connector – with the help they need to enroll in coverage. And agents and brokers have the opportunity to offer their services to some of the hundreds of thousands of interested consumers reached by Enroll America’s 200 staff, more than 13,000 active volunteers, and thousands of partner organizations.
By following these steps to make sure partnerships make sense and appropriate safeguards are in place, non-profit organizations can ensure their work with private sector partners doesn’t violate their commitment to consumers. And conversely, a clear framework give private sector groups clarity about what to expect when they work with non-profit groups, and make it easier to evaluate what makes sense for their business. These sorts of questions will continue to arise, and there aren’t always easy answers. But the Affordable Care Act was built on a foundation of public sector, private sector, and non-profit sector cooperation. Non-profit groups should not shy away from certain partnerships simply because the partner has a vested interest in enrollment; indeed, by instituting clear guidelines focused on protecting consumers, these partnerships can be very effective. Through this kind of cross-sector collaboration, we can ensure the entire health care community is coming together to meet the needs of Americans who want to enroll in coverage.
Anne Filipic is the President of Enroll America