Stakeholders Form Nonprofit Group To Boost Health Insurance Enrollment

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By Sara Hansard

A broad coalition representing most stakeholders in the U.S. health care system launched a nonprofit group Sept. 14 to enroll tens of millions of people in health insurance by 2014, when insurance exchanges are to open in all states and major health care reform law changes will take effect.

Forty-three organizations are participating in the group, Enroll America, including hospitals, health insurance companies, and pharmaceutical companies, as well as groups representing physicians, nurses, community health clinics, consumers, and people with major illnesses and disabilities.

Several Enroll America organizations have experience enrolling people in health care programs. Among them is the Maryland Citizens' Health Initiative, which helped the state increase enrollment in its Medicaid program to 70,000 from about 25,000 when the state expanded its health care program for the poor in 2007.

“Enroll America is truly an unprecedented collaboration among diverse groups across the health care sector,” Rachel Klein, executive director of Enroll America, said during a telephone press call.

Enroll America was organized by Families USA Executive Director Ron Pollack, who is Enroll America's chairman. Klein was previously deputy director of health policy and director of Medicaid and the Children's Health Insurance Program at Families USA, which advocated for the Patient Protection and Affordable Care Act.

Enroll America has two primary goals, Klein said. It will organize a “massive public information advertising campaign,” to be launched in 2013, to make sure people know about new opportunities to get health care coverage under PPACA.

A poll released Aug. 29 by the Henry J. Kaiser Family Foundation found that almost half of uninsured Americans do not know there will be new health insurance coverage opportunities in 2014, Klein noted. “Our public information advertising campaign will help close that gap so that millions of uninsured Americans will know there is health coverage available to them and how to enroll in it,” she said.

Best Practices for Streamlined Enrollment

Enroll America also has established a best practices institute to promote enrollment processes that are simple, streamlined, and “seamless,” meaning people can move easily from one program to another, Klein said. The group will encourage states and the District of Columbia, where the exchange markets will be based, to adopt enrollment and renewal systems that are “consumer-friendly and easy for people to navigate,” she said.

That includes such efforts as using a single, simple application for all health insurance programs for lower-income people, Medicaid, CHIP, and the tax credit subsidies that will be available through the exchanges, according to Ten Ways to Make Health Coverage Enrollment and Renewal Easy, a paper on Enroll America's website.

Organizations have committed more than $6 million so far to Enroll America, Pollack said. Commitments of $2.5 million have been made by pharmaceutical companies; $1.5 million by health insurers; $1.3 million by foundations; and $825,000 by hospitals, he said.

Speakers on the conference call emphasized the importance of getting people enrolled in health insurance in light of a Sept. 13 Census Bureau report. It showed that the number of people without health insurance rose to an all-time high of 49.9 million people, 16.3 percent of the U.S. population, in 2010 (see related item in this issue).

“Hospitals and their staffs know only too well the consequences of no coverage,” through use of emergency rooms by the uninsured, Rich Umbdenstock, the American Hospital Association's president and chief executive officer and a board member of Enroll America, said during the press call.

Each year hospitals provide an estimated $39 billion in care for which no payment is received, Umbdenstock said. Much of that is passed along to private payers in the form of higher rates for health care services.

“Private payers not only cover the unpaid cost of uninsured patients, they also fund the growing shortfall for both Medicare and Medicaid, to the tune of $36 billion,” he said. The figures are based on 2009 data, he said.

Uninsured Coverage Will Affect Cost Shifting

“If the uninsured get the coverage they need, they'll make a big impact in addressing the existing cost shift that's passed on to the private payer,” and their health will be improved, Umbdenstock said.

Anthony Barrueta, senior vice president of government relations at health insurer Kaiser Permanente and a member of Enroll America's board, said his managed care company believes “it's imperative to have as many people eligible for coverage get enrolled for the coverage that's available.”

That will help ensure that the health insurance exchange markets that will be established in the states “are stable and sustainable,” Barrueta said. Getting as many people as possible covered “will help us accelerate the progress already being made on improving the affordability and quality of our health care system,” he said.

According to projections by the Congressional Budget Office, 32 million to 34 million people who are uninsured now will be covered under PPACA, Pollack said. Previously, he said, many people never got enrolled.

Medicaid will be expanded by about 18.5 million people in 2014 under PPACA, Roger Schwartz, executive branch liaison of the National Association of Community Health Centers and a board member of Enroll America, said. NACHC provides medical care to about 8 million people on Medicaid, about 14 percent of all Medicaid beneficiaries, he said.

Pollack said: “We've got all of the major stakeholders in America's health care system dedicated to this one purpose of making sure that everybody who is eligible for health coverage gets enrolled.”

One major group that is not represented in Enroll America's membership is employers. “We're in discussions with several business groups, and hope that we'll have representation from the business sector sometime in the near future,” Klein told BNA in an e-mail.

Although Families USA has aggressively supported PPACA, Pollack said, Enroll America “was not created, nor will it function in a way that tries to deal with any general aspects of health care policy, either support or opposition or modification to the Affordable Care Act.”

The August 2011 Kaiser Health Tracking Poll is available at . Ten Ways to Make Health Coverage Enrollment and Renewal Easy is available at .


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