Thinking Local: Community Coalitions Provided The Key To Enrollment Success

The second Affordable Care Act open enrollment period (OE2) came to a close on Sunday, and we know that 11.4 million Americans now have quality, affordable health coverage through the Health Insurance Marketplace and Medicaid, providing peace of mind and financial security in 2015. Many of the lessons we learned in OE1 and applied to OE2 enrollment proved true, but what was the key difference in enrollment this time around? To me, the biggest change was the shift from a national program to community-based coalitions. From the dense Haitian immigrant neighborhoods in Miami to the rural landscape of the Rio Grande Valley in Texas, local coalitions in this enrollment period did more to reach the uninsured as they learned how to meet the unique needs of their respective communities.

We knew from day one that the bulk of our outreach efforts would be rooted in local communities. When the first open enrollment period began, a big national effort was needed to introduce the country to the health insurance marketplaces, and the financial assistance that was available for the first time. That national push helped to raise awareness of the new options and gave energy and attention to the effort, resulting in over 8 million consumers enrolling in coverage, far exceeding all predictions despite the widely publicized technological barriers. But there were still millions more who stood to benefit and missed out on the first year.

Some experts argued that the low-hanging fruit had been picked during OE1, and it is certainly true that the smaller pool of the uninsured made it more challenging to find consumers who were interested in enrolling. But while consumers in year two were harder to reach, they weren’t necessarily harder to convince once they had the facts about their options. That’s why in year two, there was a greater need for local coalitions to come together to spread the word in their communities. More effective partnerships formed to dive deeper into communities and reach consumers who still lacked the facts about the new options.

These partners also played a critical role in amplifying a unified message to the uninsured. Established and trusted voices in communities can sometimes do a better job of reaching consumers with enrollment information than mass-produced ads or viral videos. Our campaign worked hard to engage public officials, faith leaders, trusted community members, and medical providers and to empower them to spread the word to the uninsured in their networks, creating a multiplier effect. In Jacksonville, Florida, for instance, the Regency Square Mall donated more than 10,000 feet of space to serve as an enrollment hub throughout OE2, and the local school district sent out a robocall to alert local parents to the free enrollment help available at the mall. At one event, nearly 40 percent of the 250 attendees said they learned about the opportunity via the robocall program.  Partnerships like these allow us to meet consumers in community hubs, like the local shopping mall, and through trusted voices they are used to hearing from, like their child’s school.

All told, our coalition of partners grew by more than 50% to over 4,600 organizations. Because of that growth, the enrollment coalition is stronger than ever and was able to reach more consumers in communities. We held more than 2,300 trainings to help community partners better understand how to reach their constituents. We held more enrollment events, including more than 600 events with bilingual assisters in the final month of open enrollment. We also built tools that partners could use, like the Get Covered Connector, which allowed consumers to make appointments with free in-person assisters. All told, we directly reached more than 6 million consumers with enrollment information, a big increase over our reach during the previous enrollment cycle, even while the enrollment period was half the length and national attention waned.

As we look to future open enrollment periods, we must continue to find ways to reach those who remain uninsured, as well as those who have the opportunity to renew their coverage. Empowering local organizations and leaders with the tools to continue to do this work will be essential to our success.  We are well positioned with the growing coalition of diverse partners at the local level, and we know that the community-based enrollment infrastructure that has been built so far will help to make health coverage a way of life and institutional reality for years to come.



Anne Filipic is the President of Enroll America

Morning Consult