Availability Does Not Ensure Access: Unlocking Pennsylvanians’ Access to Health Insurance
November 19, 2014 | By: Erin Ninehouser, Pennsylvania Health Access Network
Erin Ninehouser currently serves as the Education and Outreach Director for the Pennsylvania Health Access Network, a statewide policy, advocacy, and direct service organization. PHAN is a federally-funded Navigator and is focusing enrollment efforts in rural communities. Erin coordinates PHAN's statewide network for enrollment assisters, a forum for resource-sharing, learning, troubleshooting and support serving more than 100 assisters.
The Affordable Care Act (ACA) has made health insurance available to millions of Americans. But making coverage available to individuals doesn’t ensure access. In order for individuals to have access to the full array of health benefits available from the ACA, they must first enroll (or re-enroll) in a health plan.
Pennsylvania was successful during the ACA’s first open enrollment period last year, with nearly 320,000 uninsured individuals signing up for coverage through the health insurance marketplace. This occurred despite website outages and wait times. However, continued access to care means ensuring that those individuals keep their coverage by re-enrolling in a health plan. In addition, there’s an estimated additional 400,000 Pennsylvanians who are still eligible for coverage under the ACA, but have not enrolled in a health plan.
Pennsylvania hospitals have long been a trusted source of health care information in communities. They have always taken an active role in connecting uninsured patients with the limited options available for coverage. With the ACA’s second open enrollment period available now through December 15, the need for consumer information and enrollment (and re-enrollment) assistance is critical.
However, reaching out to the uninsured will prove to be even more difficult for a variety of reasons:
- The uninsured may have been without insurance for a long time, or may have never had it
- They may be less familiar with their choices or not realize that financial help may be available
- They may have limited education or language barriers
These and other well-documented facts are a stark reminder of the difficult work that the enrollment community must do to educate the uninsured in order to bridge that gap between availability of insurance and access to the full array of health benefits.
Fortunately, the enrollment community has come together and developed a variety of important resources that can assist you in your efforts.
At the Pennsylvania Health Access Network, we’ve developed a variety of resources that can assist you. If your hospital is hosting enrollment events or office hours for walk-in appointments, make sure you are listed on these publicly available PHAN resources: Online List of Health Care Enrollment Events in Pennsylvania and Online List of In-Person Assistance in Pennsylvania.
If you have not done so already, consider having your hospital become a certified application counselor organization, which allows your organization to train key staff—patient financial counselors, health educators, and others who work directly with uninsured patients—to provide one-on-one enrollment assistance to those needing coverage. The Pennsylvania Health Network has a variety of additional resources and information to connect certified application counselors with the latest information, resources, training, and tools.
As you plan your outreach and enrollment efforts, I encourage you to keep in mind the following key messages that are most effective in motivating the uninsured to seek out information and enroll:
- Reassure consumers the process is easy
- Emphasize the need for insurance
- Discuss opportunities for financial help
- Emphasize that there’s a variety of plans from which to choose
- Remind consumers that free, in-person help is available
- Emphasize that there’s an enrollment deadline (and penalty if not enrolled)
In addition, Enroll America provides publications, best practices, and maps and data to target the uninsured. The Kaiser Family Foundation provides a number of consumer education resources, along with data to assist you with outreach efforts.
Regardless of the path your organization chooses in its enrollment and re-enrollment efforts, there’s a tremendous opportunity to improve the health of our state and nation through access to health insurance. The Pennsylvania Health Access Network looks forward to partnering together with you to get all Pennsylvanians covered.