screen shot of the home page for healthcare.gov
The next enrollment period for health insurance through the online federal marketplace starts Nov. 15.

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<p>As this year’s enrollment period for health insurance through the Affordable Care Act approaches, advocates are getting ready.

By Rose Hoban

Three organizations are on the receiving end of federal grants to help health insurance consumers buy Affordable Care Act coverage through the federal online insurance exchange for the coming year.

Officials from the federal Department of Health and Human Services announced the recipients for the “navigator grants”  Monday, totaling about $2.8 million. The money is for training and supporting “in-person” assisters to help people sign up for coverage during the enrollment period that runs from Nov. 15 to Feb. 15.

Legal Aid of North Carolina will receive $2.3 million to coordinate the work of eight other organizations around the state. Last year, Legal Aid was one several organizations that trained and deployed navigators, people who are trained to walk consumers through the process of signing up for health insurance on the healthcare.gov website, answering questions about coverage and troubleshooting the process.

This year, Legal Aid will be the lead organization for a consortium of not-for-profits that will send navigators around the state to help people enroll.

Lessons learned

Leaders from Legal Aid’s effort last year to enroll consumers said they learned plenty to make this year’s process work more smoothly.

Jennifer Simmons, Legal Aid’s project director for the enrollment drive, said both paid and unpaid navigators worked throughout the state in community health centers, hospitals, social service agencies, churches and libraries.

“One of our new consortium partners even had a spot in the mall in Gastonia.… They had a storefront,” Simmons said. “Our partners thought it was wonderful; consumers loved it, the mall loved it.”

Nyi Myint, who coordinated the work for the Alcohol/Drug Council of North Carolina last year and will do it again this year, said a lot of the work is like “planting breadcrumbs” for people to follow.

[box style=”0″]

Navigator Grants for North Carolina – 2014

·         Legal Aid of North Carolina, Inc. – $2,300,000
·         R&B Solutions – $76,795
·         Alcohol/Drug Council of North Carolina – $427,610[/box]

“When you sit with someone, you might think they’ll select a plan now, but that’s not the case,” Myint said. “If I asked you about your insurance, you’d want to think about it, and that’s reasonable.”

Federal officials found most consumers had to make multiple visits to the healthcare.gov website to complete their applications and choose a plan. Myint said it was the same thing with the navigators – most people needed more than one appointment before they clicked “buy.”

So, he said, his agency had to have enough navigators to respond to surges in demand. It stretched its grant last year by hiring on a part-time basis people who were already connected with substance-abuse treatment centers around the state.

“The goal was to go have the navigators work six to eight hours a week. They were able to engage the folks they knew in the community already,” Myint said.

He also said that even before the website went live, his agency had printed out thousands of paper copies of the application because they knew not all of the folks they met would have access to a computer.

“And it turned out that when the website wasn’t functioning well, we were poised to take advantage,” Myint said. “So we had about 10,000 applications done by November.”

The next enrollment period for health insurance through the online federal marketplace starts Nov. 15.

He said the hard copy of the application also made a good worksheet for folks who subsequently sat down at a computer to sign up.

Best practices

Sean Driscoll, Legal Aid’s communications director, said another reason North Carolina enrolled so many people was that his agency set up a statewide toll-free hotline, 1-855-733-3711.

“Anyone could call to schedule an appointment with a navigator,” he said. “That was one of the reasons North Carolina was in the top states for enrollment.”

Other states have now adopted that strategy as a best practice.

By the end of the enrollment period last year, more than 357,000 North Carolinians had signed up for plans through the federal online health insurance exchange. North Carolina’s enrollment was one of the strongest in the country; the state had almost double the anticipated number of enrollees.

A recent poll by the Kaiser Family Foundation found that programs to assist consumers buying insurance – often for the first time – were key in getting enrollment numbers up.

The Congressional Budget Office has projected that a total of 13 million people will enroll in insurance from the federal exchange in 2015, an additional five million over the number who signed up during the first open enrollment period that ended in March.

“I’m sure this year [enrollment] will be higher here,” Simmons said.

Driscoll said many of Legal Aid’s traditional customers overlap with people who were applying for coverage through the Affordable Care Act.

“The Affordable Care Act is almost more than a health care issue; this is a public-benefit issue,” said Driscoll, who noted that Legal Aid often represents people who have been denied Medicaid, Medicare or Social Security benefits.

“Public benefits is one of our bread-and-butter issues,” he said. “One of our motivations for doing this is that down the road we’ll be involved in the ACA by virtue of the fact that we’ll represent clients in appeals of denials. So by the time that comes around, we’ll be experts.”

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