Hospitals, hospital groups and commercial health insurers are backing a major public exchange market support organization this year.
Enroll America focuses mainly on helping nonprofit organizations enroll people in Patient Protection and Affordable Care Act (PPACA) exchange programs in states in which the U.S. Department of Health and Human Services (HHS) runs the exchange program. The group recruits exchange helpers, trains them, helps the volunteers organize events, and provides enrollment information technology support.
The second PPACA exchange program open enrollment period starts Saturday and is set to run until Feb. 15. Regulators and insurers developed the enrollment calendar system to minimize antiselection, by discouraging consumers from waiting until they get sick to pay for coverage.
Consumers can buy individual coverage during the open enrollment period without showing they have gone through a major life change or have some other acceptable reason for applying for coverage through a special enrollment period. Small employers can buy Small Business Health Options Program (SHOP) exchange coverage during the open enrollment period without having to meet minimum employee participation requirements.
Enroll America says it has raised $20 million this year. That’s down from $27 million for the first open enrollment support effort, but it should be enough to pay for major volunteer training and organization efforts, the group says.
Enroll America is now working with about 4,600 organizations, up from about 2,500 in April.
In some markets, traditional insurance producers and nonprofit exchange helpers view each other as competition. In other markets, the producers and nonprofit exchange helpers have worked together on exchange enrollment efforts at least some of the time.
To learn more about what Enroll America is up to, read on.
1. Hospitals are big Enroll America supporters.
The presidents of the American Hospital Association (AHA) and the Catholic Health Association of America (CHA) sit on the Enroll America board, and Enroll America says 17 percent of the new round of funding came from hospitals.
Hospital executives have been ecstatic this year about the effects of the PPACA Medicaid expansion program on the percentage of patients who come through the door with some kind of health coverage.
In addition to the AHA and the CHA, hospitals on Enroll America’s new list of significant funders include CHE Trinity Health, Catholic Health Initiatives, CHRISTUS Health, The Robert Wood Johnson Foundation, St. Luke’s Health Initiative, and the Tennessee Hospital Association.
2. Some big insurers also support Enroll America.
The board of Enroll America also includes representatives from Blue Shield of California and Kaiser Permanente.
This year, the list of big insurance industry donors includes both of those companies. It also includes BlueCross BlueShield of Tennessee and Independence Blue Cross.
3. Enroll America is trying to emphasize use of some of the same kinds of marketing strategies a commercial insurance marketing organization might use.
Enroll America says it hopes it — and the groups it helps — will be able to have outreach workers see 1.4 million people in 11 states in person by Feb. 15.
The group has about 200 staff stationed in those 11 states, and it has recruited and trained about 2,000 additional certified application counselors (CACs) there.
The CACs will provide in-person assistance.
“Outreach data showed that consumers who got in-person assistance were twice as likely to successfully enroll as those that did not,” Enroll America says.
Enroll America has also introduced a Get Covered Connector online appointment scheduling system. Exchange helper organizations are using the system even in states outside the 11-state core market area, the group says.