The President’s Immigration Actions to Lead to a Healthier California

Statement by Anthony Wright, Executive Director of Health Access

Last night President Obama announced he would be taking executive actions to improve our immigration system, including providing many immigrant families in California and the nation with temporary relief from deportation.

REMOVING DEPORTATION DISRUPTIONS: President Obama’s order to allow immigrant families to stay together is a huge benefit to the health of California’s economy and our society. The threat of deportation for immigrant family members puts unhealthy stress on our residents and citizens, and has been disruptive to California families, schools, our communities and our economy. Fears of deportation of family members prevented many legally-residing Californians from seeking care and coverage. With this order, these families won’t have to think that seeking basic care might lead to the deportation of a loved one.

CALIFORNIA’S CURRENT POLICY: While the President’s order continues to exclude undocumented immigrants from federal health benefits, including even those granted deferred action, California has the ability, the history, and the decency to include these Californians in our health coverage and care programs, under existing law. In effect, this means that the President’s actions expand health coverage to those low-income working families, under California’s existing Medi-Cal program, allowing them to get more cost-efficient primary and preventive care, rather than just at the emergency room.

While the exclusion from federal benefits stands, immigrants with “deferred action” status who are at or below the poverty level will be able to get Medi-Cal coverage as an entitlement under existing California law–and this should include those provided relief under the President’s order. California has long covered certain immigrant populations excluded by the federal government, including recent legal immigrants (under the “5-year bar”), refugees (and other “people residing under the color of law”) and recently DREAM ACT students (and others under “deferred action”). The President’s executive order thus expands those eligible for state Medi-Cal, effectively a continuation of these commitments.

PROUD OF CALIFORNIA LEADERSHIP: While Congress has dithered and delayed, California should be proud to lead in efforts to include immigrants in our society, and in our health system. In California, we know our society and economy are better when all children can get educated; our roads are safer when everybody is able to go through the testing process to get a driver’s license; and we know that health care system is stronger when everyone is included. Californians should be proud that our existing state laws already provide health coverage to many of these immigrant families granted deferred action–and should take the modest additional steps to provide coverage for all Californians, regardless of immigration status. This is another way California can again lead the nation on immigration issues.

NEXT STEP SHOULD BE #HEALTH4ALL: We applaud the foresight of Governor Brown and the Legislature in extending Medi-Cal, including state-funded Medi-Cal for immigrant populations that will now include those granted administrative relief.  We therefore urge the Governor and Legislature to take the next step to cover all Californians, which is now even more achievable that the remaining gaps in eligibility are even smaller.

As the President has reaffirmed, our undocumented friends and neighbors are crucial parts of our economy and community–they should be fully included in our health system as well. We strongly support state and county level proposals to extend health coverage to all Californians, regardless of immigration status–building on SB1005 (Lara), introduced earlier this year and various efforts to expand coverage at the county level in the coming year. When and where Congress fails to act, California can and should lead. Our health system is stronger and more effective for everybody when everybody is included, when we provide cost-effective primary and preventive care up front and not just expensive treatment, often too late, in the emergency room.

Covered California Board Meeting Update

Today, the Covered California Board met for a public meeting that began around 1:30pm and ended at about 3:30pm. With open enrollment underway, much of the discussion at today’s Board meeting centered on outreach and enrollment efforts, including the recent Covered California Bus Tour, enrollment thus far and what enrollment will look like this year as we integrate the renewal process for the first time. The just released DMHC audit of Anthem Blue Cross and Blue Shield of California was also a highlight of today’s discussion.

Renewal and Enrollment – The Covered California Bus Tour started on Monday, November 10th in Sacramento, traveled through northern, central and southern California cities, and hit its final destination in Redding on November 18th. Peter shared a story of a woman named Diana whom he met during the Bus Tour in Fresno. Diana lost her employer based coverage over a year ago and went uncovered for quite some time because she thought the process would be hard. She had been feeling sick for awhile until she finally signed up for coverage. Shortly after she signed up, she had a doctor visit where she found out that she had a very aggressive form of uterine cancer. She is now better and credits Covered California for saving her life.

Peter shared that as of November 18th (in just four days) close to 70,000 people have been determined eligible for coverage. Last year, it took two weeks to get this many people enrolled, said Peter. This year, it took just four days to reach this number. This is a testament to the outreach, enrollment and education efforts thus far; consumers are informed, ready to sign up and there are knowledgeable agents, county eligibility workers and organizations ready to help them. With respect to the renewal process, Covered California sent renewal notices in October. Consumers have 30 days to shop and choose coverage before Covered California renews their coverage automatically. Those who were automatically renewed will be able to change plans through the end of open enrollment on February 15, 2015. Consumer advocates weighed in during this segment of the meeting, asking that more be done to improve the accuracy of notices and confusing nature in which duplicate notices are sent to consumers with conflicting and/or confusing information. As for the Covered California website, it has been re-launched, said Peter, and is cleaner, flows better and the English Spanish translations have been improved. that are going out to consumers.

Department of Managed Health Care Non-Routine Survey of Anthem Blue Cross and Blue Shield of California – Following complaints from consumers, in June of 2014 DMHC initiated a formal non-routine survey to assess the accuracy of the provider directories of two of Anthem Blue Cross and Blue Shield of California. The major findings of the survey were presented during today’s Board meeting. The survey confirmed what they had already known, she stated, which was that provider directories were inaccurate. DMHC has engaged in action with the plans to address the issue of inaccurate provider directories. In 6 months, DMHC will do another review to determine whether the plans have followed through on whoops my phone necessary corrective action. Covered California reviewed there own actions to address the issue–using their active purchasing power negotiating with the plans, educating doctors and providers about their issue, working with DMHC, etc.

The next Covered California will be held December 15th (new date!) and the Board plans to discuss Qualified Health Plan Recertification before they make final QHP Plan changes in January.

Affordable Care Act as a Tool for LGBT Equality and Wellness!

This blog post was written by Kate Burch, Network Director, California LGBT HHS Network

One of the projects that Health Access supports is the California Lesbian, Gay, Bisexual, and Transgender Health and Human Services Network, a coalition of organizations throughout the state working towards improving wellness in LGBT communities.

We are excited that open enrollment started on Saturday! The Affordable Care Act has cut the number of uninsured people in half in California, and that’s especially important for LGBT communities. LGBT people have a long history of being discriminated against, denied access to insurance, and refused medical care. We are more likely to be uninsured, and fear of discrimination makes us less likely to go to the doctor when we need to.

But the Affordable Care Act is changing all of that. The Affordable Care Act and Covered California are amazing tools for equality. Our families can get affordable health insurance right now. We can’t be discriminated against any more. We can’t be denied care or charged more just because of who we are.

The first step toward equality in health is getting covered. We are leading a statewide effort to get LGBT people enrolled, working with more than 12 LGBT organizations throughout the state to make sure that LGBT people can get their health insurance questions answered. Our #LGBTcovered website (http://www.californialgbthealth.org/lgbtcovered.html) lists office hours for organizations around the state that can answer LGBT-specific enrollment questions, and we will be holding enrollment events throughout the open enrollment period (November 15, 2014-February 15, 2015). We are also working with Out2Enroll (http://out2enroll.org/) to promote the national effort to increase the number of LGBT individuals and families with health insurance.

Websites, social media, and enrollment events are a great way to get the word out about open enrollment. We know, however, that the best way to improve health in all of our communities is one-on-one. So between November 15th and February 15th we urge all of you to talk to everyone you know to make sure they’re covered.

Getting On The Bus…

This Monday morning, Covered California is embarking on a nine-day, 21-city bus tour through the state to highlight the beginning of open enrollment to take advantage of new health insurance options and financial assistance to get covered.

I’m excited to be at the 8am launch in Sacramento at the State Capitol, and to get on the bus for at least a portion of the ride, tweeting and posting some thoughts during this week leading up to the first few days of open enrollment — a three-month window of time from Nov. 15 to Feb. 15 when Californians who need insurance cannot be turned away by health insurance companies and when many can get federal subsidies to dramatically lower their cost of coverage.

On the bus will be Peter Lee and other leaders of Covered California, and community partners and elected officials will make appearances at enrollment events and storefronts to encourage uninsured Californians to obtain health coverage during the open-enrollment period through Covered California.

The tour will include stops in Petaluma, Gilroy, Fresno, San Bernardino, Palm Springs, San Luis Obispo, Salinas, Chico and Redding, as well as stops in major cities such as Los Angeles, San Francisco and San Diego.

So we hope partners join in on the tour, and more importantly start to tell their communities about the opportunity for the peace of mind that comes with coverage.

Supreme Court to Hear King vs. Burwell: No Impact on CA, But Outrageous for the Nation

Just hours ago the Supreme Court voted to take on the most significant challenge to Obamacare since 2012:  King vs. Burwell, which contests the subsidies available to qualified enrollees in the 36 states that have federally facilitated marketplaces or FFMs (get details at Scotus blog). The case is based on an hyper-literal mis-reading (as in blind to the rest of the ACA) reading of Section 1311 of the ACA, which says that subsidies are available to people “enrolled in through an Exchange established by the State under 1311″ (our emphasis). It takes a minimum of 4 votes to hear a case, and since the case and a related Halbig vs. Burwell decision, met with conflicting rulings in lower courts it was fair game for SCOTUS.

Even though this case has *no* impact on California (none. zero. zilch.), it is ridiculous that the Supreme Court has taken this, and risked the financial help and coverage for over 4.7 million Americans. As Judge Davis wrote in concurrence in a lower court decision, “What [ACA opponents] may not do is rely on our help to deny to millions of Americans desperately – needed health insurance through a tortured, nonsensical construction of a federal statute whose manifest purpose, as revealed by the wholeness and coherence of its text and structure, could not be more clear.”

Without subsidies, health reform in the impacted states could become unraveled. Nationwide 87% of exchange enrollees received subsidies. If the subsidies are no longer available, the federally run exchanges will become a magnet for older and sicker individuals, thus causing those marketplaces to go into a death spiral. Costs go through the roof for everyone left, and the marketplace dies as a result.

Since it took exactly 4 votes to take on a case, this means 4 justices are prepared as they were in 2012 to gut the ACA. This also means that the fate of arguably the most critical provision of the law rests, just as it did in 2012, in Chief Justice John Roberts’ hands.

Back in 2012 Chief Justice Roberts singlehandedly upheld the law—but the provision that he made optional to the states, the Medicaid expansion, is strikingly similar to the subsidy issue.  As a condition for “saving” the law, Roberts wanted even more flexibility than was already built into the law. It turns out most of the states that have rejected the Medicaid expansion are also states with FFMs. Some of these states will try to become state-based exchanges like Covered California, but not all.

California has a story to tell…

California has a notably successful state-based exchange, which means that the final ruling even if it turns out badly, will not apply to California. But, if the SCOTUS ruling on King vs. Burwell turns out badly, states will need fresh arguments to set up their own exchanges. Having slashed the number of uninsured in half and also slowed the growth in premium rates also by about half, California can be a model in this regard, though with plenty of lessons for these states.

As Jeffrey Toobin has argued, the Supremes do read the newspapers. On hot button issues like abortion and affirmative action, their opinions will typically reflect the tide of public opinion. Recent polling shows that 64% of the American public does not want to overturn the law, rather they want to improve upon it. But an unfavorable ruling on King vs. Burwell will foreclose this option.

Scientific polling is helpful, but not enough. Now is the time to pull out all the stops and share ACA success stories from the golden state…

Click here to share stories about how the ACA has helped you:

  • Financial security: It’s freed up resources in the family budget for worthwhile expenses like college or more nutritious food.
  • Cost effective: you’ve stopped getting primary care at the emergency room.
  • It’s caught diseases early, while they are still treatable and less expensive to treat.
  • It’s helped you manage a chronic condition by giving you access to cost effective, coordinated care in a clinical setting.
  • It’s created peace of mind that your insurance will be there at your time of need.

The clock is ticking. The Supreme Court will hear the case early in 2015, and their ruling will come out in June.

President Obama on post-election plans on health care and immigration

President Obama just finished speaking to the public following the election. If you missed it, here is what he said on immigration and healthcare, as reported by our own Sawait Hezchias-Seyoum:

On immigration, President Obama stated that in the absence of action by Congress, he will via executive authority take action to improve the immigration system before the end of the year.  In response to questions from reporters around concerns raised that EA would make it harder to pass immigration reform, the President expressed that there is a cost to waiting to pass immigration reform. He referenced the recent issue of unaccompanied children, how that represented a major crisis in our immigration system and further, that it identified a real problem with respect to our border.  He added that where he has EA to address the problem with our border and specifically the impact that the misallocation of resources has had on our ability to enforce border control, he would use it.

On healthcare, the President will not entertain any efforts to take away health care from people nor recommendations for changes that would undermine the structure of the law.  He reminded people that there is no law that has ever been passed that is perfect, that there are areas where we know we can do better and he is open and receptive to responsible changes to the ACA.  He added, despite all the contention surrounding the law when it was passed, we now know the law works, millions of people who didn’t have insurance before now have it and despite predictions, even as we’ve enrolled more people into the system, health care inflation has gone down and we saw the lowest increase in health costs in 50 years which has resulted in $150 billion in savings to the federal government.

Full Steam Ahead on Enrollment and Continuing Health Reform in California

On health reform, last night was a missed opportunity in many states, where gubernatorial candidates that would have been open to doing the Medicaid expansion didn’t win, in states like Kansas, Georgia, Florida, Maine, and Wisconsin.

Whatever the election results were across the country, in California supporters of the Affordable Care Act hold onto strong legislative majorities and all statewide offices. This result builds momentum for open enrollment starting in 10 days on November 15th, and for additional improvements in the California state legislature–even including rate regulation, the subject of the defeated Prop 45.

ON THE ACA/OBAMACARE: Patients will be pleased we can shift from the political rhetoric of ‘Obamacare’ and the practical benefits and new options available under health reform, with open enrollment starting in 10 days, on November 15th. With Affordable Care Act supporters winning strong legislative majorities and all statewide races in California, it’s full steam ahead to get people enrolled, and to continue to implement and improve upon the law.

In a handful of places, we were surprised that the political debate about the law seemed so disconnected from the positive results on the ground. For example, if Doug Ose returns to Congress as a Representative for the Sacramento region, it will be interesting to see if he really votes to repeal coverage for so many of his constituents. But the Affordable Care Act isn’t going anywhere under President Obama, and Californians should take advantage of the benefits and options available with open enrollment starting soon.

ON PROP 45: The insurance industry clearly had the money to bury Prop 45, and they did. Even though Prop 45 was overwhelmed by a well-funded assault of misleading ads, it’s notable that the insurance industry didn’t run a campaign against the concept of rate regulation–just to the specifics of this particular proposal. In fact, the opposition campaign to Prop 45 explicitly re-affirmed the Affordable Care Act, health reform, and the need for insurance company oversight.

We expect the rate regulation debate to return to the legislature, possibly with more momentum, Previous health reform initiatives on HMO patient rights (1996) and prescription drug costs (2005) lost by similar margins at the ballot, but were passed by the legislature and enacted soon afterwards. We will continue to advocate the simple point that patients shouldn’t have to pay premiums deemed unreasonable by regulators.

So even as the national debate may continue to be about going backward on health reform, the California discussion should continue to be about moving forward.

Health Care Is On The Ballot

HEALTH ACCESS UPDATE: Monday, November 3, 2014 

VOTE TOMORROW: HEALTH CARE ON THE BALLOT

*        Several races, from Governor to state legislators, will have an impact on the future of health reform in California. County Supervisor races will impact your local health care safety-net. Whether to repeal “Obamacare” has been a key issue in some California Congressional races, with stark contrasts between the parties.

*       Some ballot measures also impact on health policy. In particular, Prop 45, supported by several consumer groups, would give authority to the Department of Insurance to approve or reject health insurance rates.  VOTE YES ON 45!

Tomorrow is election day, and health care is on the ballot, along with many other issues. The future of health reform will be decided in both statewide races like that of Governor, Insurance Commissioner, Attorney General, and others, and in local races for Congress, the State Legislature, and County Boards of Supervisors.

Find your polling place here: http://www.sos.ca.gov/elections/find-polling-place.htm.

In particular, “Obamacare”–and whether it should be repealed–continues to be an issue debated in television ads in key Congressional districts. For example, ads in the 7th Congressional district in Sacramento accuse Rep. Ami Bera of supporting “Obamacare,” even though he wasn’t elected yet when it was passed; counter-ads accused Rep. Doug Ose of seeking to repeal the law and the consumer protections within it, which would leave many without coverage and help in getting health care. That race, and others up and down the state, are seen as closely contested and contentious.

The makeup of the California Legislature will also be determined Tuesday, and with it, the state’s ability to continue its leadership in health reform. The California Legislature has been a leader in implementing and improving upon the Affordable Care Act–passing several dozen laws to improve on, the reforms and protections of Obamacare. How that continues depends on state Senate races from Bakersfield to Orange County, and Assembly races from Southern California to the Central Valley.

County races from Los Angeles to Fresno will also impact the your health care as new faces on a county’s Board of Supervisors will make determinations about the county’s health care safety-net in this time of transition in health care, impacting not just the remaining uninsured, but the health system on which we all rely.

Obviously, the most central position with regards to the future of health care is the Governor, who will determine the next few critical years of health reform, including the new Medicaid waiver being negotiated over the next year and the fate of all future bills and budgets on the topic. Other statewide offices of import include the Insurance Commissioner, which regulates a portion of the health insurance market, and the Attorney General, which oversees hospital mergers among other transactions.

A few ballot measures also focus on health care, including Proposition 45, which would give the Insurance Commissioner the authority to approve all health insurance rates in the individual and small group markets, and reject unjustified rate increases.

YES ON PROP 45: Health Access California supports rate regulation and Prop 45. California’s successful implementation of the Affordable Care Act has shown the progress that can be made in moderating health care premiums in part through more oversight on health insurers, and rate regulation is an important next step. Under the new authority given to state regulators by the ACA, insurers have to file and justify rates. To date, these transparency provisions have led to rate rollbacks and rebates of over $300 million to consumers.

At the same time, there have been other rates deemed unreasonable by regulators that the insurers just went ahead with anyway. California regulators should have the ability to reject unjustified rates, to prevent the current situation where over a million Californians are paying a premium deemed unreasonable by an expert health agency.

Rate regulation is not in conflict with the Affordable Care Act; in fact, 35 states have some form of rate regulation. The ACA’s results in terms of lower premiums and rebates shows proof of concept: that this type of government oversight works and California can and should take additional steps to lower costs and protect consumers. The progress made by Covered California in negotiating rates and benefits shouldn’t conflict with an actuarial review by a regulator who can deny unjustified rates–and is especially needed for individuals and small businesses not buying coverage through Covered California. While ACA supporters have raised legitimate questions regarding timing, jurisdictional, and operational issues, those are resolvable if the Department of Insurance works together with other key agencies like the Department of Managed Health Care and Covered California, and they have indicated they would.

Health Access and other consumer advocates have tried to advance rate regulation in the Legislature for many years, but progress was stalled due to full-court opposition from the insurance industry. Prop 45 provides an opportunity to move forward on this issue.

Remember–up and down the ballot, your health care is on the ballot. So please remember to vote!

Senate Committee on Health Informational Hearing: “The Affordable Care Act Year Two: Education, Outreach and Enrollment

On Thursday, the Senate Committee on Health, chaired by Senator Ed Hernandez, convened an informational hearing entitled “The Affordable Care Act Year Two: Education, Outreach and Enrollment”.   The hearing served as an update to legislators and the public about lessons learned from the first year of enrollment into Covered California and Medi-Cal coverage under the ACA.  Peter Lee, Executive Director of Covered California and Toby Douglas, Director of the Department of Health Care Services (DHCS) discussed current challenges experienced in enrollment and strategies being employed to improve enrollment outcomes in year two.

Toby started off and expressed that one of the biggest challenges that DHCS is experiencing is related to functionality between the two information technology systems used to process eligibility and enrollment, the Statewide Automated Welfare System (SAWS) which is used by counties to determine Medi-Cal eligibility and the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) used by the California Health Benefits Exchange. Despite challenges, Toby assured the committee, advocates and the public that some progress has been made and DHCS is working proactively with Covered California to address outstanding concerns. In particular, Toby focused on the work being done to reduce the pending applications still in the Medi-Cal backlog. Toby shared that DHCS is working on multiple improvements to the single streamlined application online that should be ready by March, the ability to deny cases in CalHEERS and also working to address the issue of consumers receiving multiple notices.  While SB 1341 (Mitchell), a bill that is now law is being implemented and offers a long-term solution to improve functionality between SAWS and CalHEERS, DHCS is also working with the counties on short term fixes, Toby shared. On outreach and enrollment, Toby shared that DHCS is working closely with counties and community based organizations to contact hard to reach populations, including African Americans and Latinos.

Peter Lee gave an enrollment update, an overview of lessons learned and challenges ahead. With regards to enrollment, 1.4 million people enrolled in health care through Covered California and out of this group 88% received subsidies. Over 2 million have enrolled into health care coverage through Medi-Cal.  Additionally, 81% of the total enrolled in Covered California, 81% or 1.1 million people have effectuated coverage and paid their first month premium.  During the special enrollment period, 200,000 signed up for coverage. This number was lower than expected: Covered California had anticipated about 60,000 people a month would enroll, but in actuality, about 50,000 people a month enrolled.  Peter shared that the Medi-Cal backlog may have impacted the progress Covered California made during special enrollment since potentially, some people who applied for Medi-Cal, but were otherwise eligible for coverage in Covered California could have applied during the special enrollment period, but weren’t able to because their applications were caught in the backlog.

Peter also provided an update of Covered California’s immigration status clearance process.  Of the 148,000 pending applications that had not been cleared due to consumers who failed to provide immigration status information, about 138,000 have been cleared.  There are approximately 10,000 consumers who have received additional notices asking for immigrations status information.  Peter Lee shared that he expects a significant number of these consumers are citizens or otherwise eligible and will be cleared for coverage as soon as they submit their immigration status information.

Both Peter Lee and Toby Douglas provided an update on the renewal process and challenges they expect.  Peter expressed that the vast majority of people who are not insured are people who have adjusted to a culture of not having coverage and as such, this is one of the biggest challenges they are dealing with as they develop their outreach and education strategies.

Toby shared the historic renewal rates in Medi-Cal; Senator Holly Mitchell responded to Toby’s statement by expressing that it was important to understand why some Californians fell off coverage so that the Legislature can be a partner in addressing the issue.

Peter closed with lessons learned. One of the biggest lessons learned, Peter shared is that people need “more than one touch”; it was more common that not that people enrolled into Covered California after hearing about coverage more than one time. Peter expressed that they will be working to ensure consumers are contacted in a variety of ways.

Senator Hernandez, Chair of the Senate Health Committee ended the first segment of the agenda by asking what it was going to take to ensure enrollment is done efficiently.  Toby (DHCS) expressed that first, it will take time and that DHCS is working on mitigating strategies for issues and challenges that may arise.  Second, it will require improved capacity of computer systems and lastly, adequate resources for counties who do enrollment.

Jim Mangia, the President and CEO of St. John’s Well Child and Family Center discussed enrollment issues related to the Medi-Cal back log.  Jim shared that St. John’s has provided care to close to 3,000 patients who have Medi-Cal applications that are pending and as a result they have experienced a loss of $2.5million in revenue.

Advocates and community organizations including Asian Americans Advancing Justice, La Familia Counseling, Community Health Councils, NAACP and Young Invincibles shared examples, stories, best practices, and lessons learned on outreach and education.  Yolanda Richardson, Chief Deputy Executive Director for Strategy, Marketing and Product Development of Covered California and Rene Mollow, Deputy Director for Health Care Benefits and Eligibility of DHCS expressed their appreciation for the partnership with the groups present and the opportunity to improve where needed.

New Energy At Covered California’s Marketing/Outreach Advisory Group

With only two weeks to go until Covered California open enrollment, it’s no wonder it was standing room only at today’s Marketing, Outreach, and Enrollment Assistance Advisory Group (MOEA) meeting at Covered California headquarters. Chaired by Health Access’ own Anthony Wright, it has been restructured:instead of separate committees representing communities of color groupings (African American, Asian/Pacific Islander, and Latino), the communities of color groups are integrated with the larger advisory group, but they can also meet apart to generate community-specific input as needed. The discussion already feels more lively and productive under the new structure.

Much of the meeting was spent digesting the lessons from year 1 of open enrollment. As noted in the meeting, Covered California staff have done a good job distilling the lessons, but the real test will be in the execution of processes designed to act on those lessons—community partners play a key role here.

As Peter Lee pointed out, starting next year Covered California will be doing more with less—and with even less in the ensuing years. All the more reason to take the lessons to heart. Here are a few to ponder as you (yes, you, or really anyone else reading this…year 2 open enrollment, being shorter than year 1, will need all-hands on deck)  prepare for open enrollment:

Highlighted Lessons from Year 1 Strategies for Year 2
Overall Covered California exceeded enrollment projections, but it fell short in certain communities, like Latino and African American. Marketing and outreach is more heavily focused on engaging specific communities.
More service center reps speaking foreign languages
Consumers were more likely to choose the best plan (maximizing subsidies and cost sharing assistance to get the best benefit package possible) if they used some form of in-person assistance Connect consumers as much as possible with assisters (enrollment counselors, navigators, and agents), while maintaining the ability to fill out applications by phone and online.
Covered California’s 81% effectuation rate (how many actually pay their first premium or “binder” payment) could be improved. Arrange for all QHPs to take binder payments on Covered California, as the final step in enrollment.  Note to plans: it’s up to you to step up to this opportunity.
Maximize retention. Work with stakeholders and advocates to make the notice clearer for all (much of this process happens in the AB1296 Workgroup)

Here are a few highlights from the subcommittees’ brainstorm on the bus tour, community outreach, messaging, and social media:

  • Partner with high-profile leaders or heroes in targeted communities.
  • Designate ambassadors to get their friends and families enrolled (give recognition and  support and maybe business cards to individuals who go above and beyond in their tweeting or retweeting activities to boost enrollment
  • Hook into local community events like fairs, planning ahead for permits and the like.
  • Train the CEEs (Certified Enrollment Entities) on the right messaging regarding eligibility by immigration status.
  • Engage cell phones in social media campaigns.
  • Use infographics to tell stories with the new messaging on the benefits of insurance.
  • Give community partners ample opportunity to review or collaborate on collateral.

 What can you do now to act on these lessons

  • Click around the Covered CA website. Notice the Find Help Near You button, but note that a new website design will be launched November 8. Prepare to promote the new site.
  • Promote the use of Covered California’s Shop and Compare Tool now, so folks are ready to renew or enroll on November 15: http://www.coveredca.com/shopandcompare/#calculator
  • Get your organization ready to piggy back on the Covered CA bus tour and the overall marketing focus on friends helping friends.