September 24, 2013

A new report by researchers at the George Washington University School of Public Health and Health Services (SPHHS) finds that intensive outreach and assistance will be needed in order to connect millions of low-income Americans with the coverage they need under the Affordable Care Act (ACA). The report, completed in partnership with the Kaiser Family Foundation with support from the RCHN Community Health Foundation, takes a look back at the lessons learned during the Massachusetts health reform effort and finds that assistance to low-income people under the national expansion will need to be ongoing in order to ensure the success of the ACA.

Professors Sara Rosenbaum and Peter Shin at SPHHS, Julia Paradise of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and their colleagues interviewed the staff at nine community health centers in Massachusetts and identified some key findings five years into the state’s health reform, which is in many ways a prototype for the national health reform effort. They found that individuals served by these centers face a host of challenges—poverty, low literacy, homelessness, lack of internet access and other factors—that must be addressed in order to get them enrolled in a health plan.

Other key findings from the study:

  • Assistance with paperwork and enrollment in health plans is not a one-time matter but must be provided at all stages in order to ensure continued coverage.
  • Immediate access to enrollment boosts the effectiveness of the outreach.
  • Even after the health reform is fully mature, there will be a need for ongoing enrollment assistance and one-on-one help.

The researchers looked back at the experience in Massachusetts hoping that the findings might help states and communities now gearing up under the ACA to start enrolling similar populations with the same challenges to enrollment.

The full issue brief, “Providing Outreach and Enrollment Assistance: Lessons Learned from Community Health Centers in Massachusetts,” can be accessed online here.