Today marks 100 days until open enrollment begins for new health insurance options under the Affordable Care Act (ACA)! New “Marketplaces” will be available in every state for people to buy private insurance, with financial help based on their income. And 33 states will be joining Wisconsin in the federal Marketplace portal. This means that there’s a lot to be done.
According to recent polling data from the Kaiser Family Foundation, people (including young adults) generally know that it’s important to have health insurance, but uninsured individuals in particular don’t know much about the ACA, or they don’t realize that it has the opportunity to help them access needed coverage. That means that there’s a big education and outreach lift for all of us committed to improving health care coverage.
Beyond the currently uninsured Wisconsinites that we have to reach (about 558,000 residents, 10% of the state population), our state will be transitioning nearly 100,000 additional adults currently on BadgerCare to Marketplace coverage, because of missed opportunities in the state budget. Though we are encouraged by recent verbal commitments by the state Department of Health Services (DHS) and the increase in fundingthat DHS included in the budget bill for Income Maintenance enrollment services, we look forward to seeing the realization of those commitments.
We hope the department’s assurances will translate into concentrated outreach efforts to the childless adults who become newly eligible for BadgerCare (some of whom are on the BadgerCare Core waitlist of more than 150,000 people), and will give current enrollees ample notice of changes to their eligibility. The uninsured and the adults being eliminated from BadgerCare will also need streamlined, no-wrong-door assistance that will likely be concentrated in county enrollment offices – to get them into whatever form of coverage they are eligible for.
All this state-run work will have to coordinate with other outreach and enrollment workers, including the ACA-funded “Navigators.” WCCF helped, through our co-coordination of the Wisconsin Access Network, to ensure that there was a statewide, collaborative, consumer-focused application for those limited federal funds. The buy-in among stakeholders, including DHS, for that coordinated effort (Enrollment4Health Wisconsin (E4Health)) has been impressive. But the effort and outreach is severely limited by funding, and we won’t know if the funding is awarded to E4Health until mid-August. To learn more about getting involved in the Wisconsin Access Network or E4Health, please contact me.
Others currently doing enrollment in community health centers, hospitals, community organizations, etc. will also need to continue and amp up their efforts. Unfortunately, a provision in the state budget instructs the Office of the Insurance Commissioner to further regulate all individuals doing enrollment functions, whether through official navigator roles or “other enrollment assistor” roles like certified application councilors. (See this national assistance chart illustrating who may be doing enrollment.) State requirements in our federally facilitated Marketplace would be on top of federal regulations. We worry that the state rules could make it challenging or impossible for current enrollment assistors to continue doing their critical work, when we need them most.
The next 100 days, and beyond, will require all hands on deck! Hopefully all critical partners and individuals will collaborate to ensure that all Wisconsinites find an insurance option in the new world of 2014.
Sara Eskrich
