This weekend, thousands of Connecticut residents will have a second opportunity to sign up for affordable insurance through the state’s branch of the Affordable Care Act.
But with a shorter enrollment period, decreased funding from the federal government and demographics that are more difficult to reach, the insurance exchange anticipates a more challenging enrollment period.
“It’s a slightly different ballgame,” said Mark Schlesinger, professor of public health at Yale and co-author of a report on the performance of Marketplace Assister Programs under the ACA. “[Last year] they created good will in communities and covered a lot of people, but this year is definitely going to be harder in many different ways.”
Access Health CT will open up enrollment for its second year of operation on Saturday. The window of enrollment will be open from Nov. 15, 2014, to Feb. 15, 2015. Consumers who sign up by the 15th of a month will begin receiving coverage on the first day of the following month.
The 90-day enrollment period is a significant decrease in time from the six-month period that Connecticut and other states allowed last year. What is more, it comes at an inconvenient time of year, said Jason Madrak, chief marketing officer of Access Health CT. While it might motivate “deadline-driven” individuals, it may also pose an inconvenience to consumers, Madrak added.
“Having a 90-day period is not optimal,” Madrak said. “And holiday season is not the ideal time to have people thinking about health insurance.”
Access Health CT hopes to counter the negative effects of this condensed timeline by emphasizing the important dates and deadlines in publicity materials.
Adding to the timing difficulties, Access Health CT will now receive less federal funding, meaning that its overall budget will decrease. However, Madrak believes that this decrease in funding will not have a significant impact on the effectiveness of the state’s outreach. Last year, Madrak said, Access Health CT needed the federal funds to extend their campaign over a six-month time period. With a significantly shorter window, the decrease in federal funds is less worrisome.
The organization will also rely more heavily on community partners — who best understand and are uniquely positioned to reach out to certain constituencies — rather than depending entirely on Access Health CT’s limited resources, Madrak said.
“They need to mobilize people faster to connect with people and get them into the system,” said Mark Schlesinger, professor of public health at Yale.
Connecticut has been touted as having one of the most successful opening years with the marketplace exchanges mandated by the Affordable Care Act. Under former CEO Kevin Counihan, who has since moved to Washington D.C. to run the federal exchange program, Healthcare.gov, Access Health CT was able to insure 187,000 of Connecticut’s 334,000 uninsured residents, bringing the uninsured rate down to 4 percent from approximately 8 percent.
Madrak attributes much of the early success to the well-designed IT system and active outreach and advertising. The Access Health CT online system was tested with thousands of permutations of family configuration and incomes to ensure the stability of the platform, he added. By the end of their outreach campaign, 80 percent of Connecticut residents were familiar with the exchange.
“An insurance exchange had not existed in the past,” Madrak said. “We were really launching a new category, or a new brand.”
But critics of Access Health CT’s performance remain. Ellen Andrews GRD ’89, executive director of the Connecticut Health Policy Project, said that insurance premiums are still too high, as they are not negotiated the way that employer-provided insurance rates are.
The people who signed up for Access Health CT are also probably those who needed health insurance and would have signed up regardless of outreach, Andrews added.
“If we’re grading on actually getting people into insurance, then no, they didn’t do very well,” Andrews said. “They got the low-hanging fruit.”
Madrak agrees that the second year will pose the challenge of requiring more outreach to key uninsured populations — generally located in urban, ethnic communities — and ensuring that advertising addresses those communities’ main concerns.
Madrak emphasized the importance of community partners, and Andrews agreed that trusted community members should play a major role in Access Health’s outreach.
Access Health CT will use new targeted media strategies this year, including buying cable television ads in five cable zones that cover the largest uninsured pockets, in addition to promoting online video campaigns, Madrak said.
With new partnerships with the Department of Labor, the Connecticut Library Association and community-based health centers, Access Health CT will be opening new full-time staffed enrollment centers where customers can get assistance in signing up. Last year, the two storefront enrollment centers in New Britain and New Haven contributed to 12 percent of enrollment, Madrak said.
Schlesinger said that Connecticut did a better job with outreach to disenfranchised communities than most states, but acknowledged that many people don’t understand how to navigate the complex health care system. State Healthcare Advocate Victoria Veltri agreed that consumers are not adequately educated on how to interpret and use their insurance policies and added that there are initiatives to increase health insurance literacy.
“With over 60 languages spoken in some counties in the state and racial, ethnic, economic, gender, geographic, educational and other diveristy of our state, we have a lot of work to do,” Veltri said in an email.
Another new challenge this year will be re-enrolling customers from last year. When customers’ financial situations change year-to-year, their insurance options vary as well, Madrak said.
Consumers will also have additional insurance plans available to them this year, provided by United Healthcare, which did not previously participate in the exchange. The state has approved the company to offer individual policies on the exchange, said Donna Tommelleo, director of communications for the State Insurance Department. The carrier previously only offered plans through employers.
“There’s more competition this year, which is always good for consumers,” Tommelleo said.
The Access Health CT enrollment center in New Haven is located at 55 Church St.