Rounding the Bend: Enrollment and Outreach Updates from the State-based Marketplaces
2015 has drawn to a close, and with it deadlines for consumers to have coverage on January 1. The Department of Health and Human Services has recently released an enrollment update, citing that over 11.2 million individuals have enrolled in plans through the marketplace, 2.7 million of which have come through the 13 states operating as State-based Marketplaces (SBMs).
In December, we provided an early account of enrollment across the SBMs. As states head toward the finish line of open enrollment they continue to ramp up their efforts to enroll individuals in coverage, including targeted outreach to the hard-to-reach and a ramp up of community events and in-person support. Below, we provide updates on activities and enrollment across the SBMs.
California chose to extend its enrollment deadline from December 15 to December 17 after receiving more than 55,000 applications during the final 48-hours of sign-up for January coverage—an increase of 23,000 applications from the same two- day period in 2014. As of January 2, Covered California reported more than 238,000 new consumers had signed up for coverage, which puts it ahead of projections. In addition, the most recent HHS data showed Covered California with 1.41 million consumers, including 1.18 million who were set to re-enroll, which is an increase of 210,000 over the previous year.
To target its enrollment efforts, Covered California used new maps that highlight neighborhood “hotspots” with high concentrations of uninsured, subsidy-eligible populations. The maps were developed using U.S. Census data and estimates of eligibility for coverage from a model of California insurance markets developed by the University of California, Los Angeles. Once regions of high uninsurance were identified, Covered California expanded the number of storefronts and community partners available in these neighborhoods and targeted local media in the preferred language of residents.
Covered California also teamed with community partners and insurance companies to open an enrollment center in the Los Angeles area, where consumers can immediately enroll in coverage. This enrollment center is the first of its kind in establishing regular hours, having prominent signage and having health insurance companies on site to provide information about benefits. Other targeted efforts included deployment of outreach teams to businesses frequented by targeted populations and a branded Covered California van (“Van with a Plan”).
In addition, Covered California reached out to new members by using “The Force” on social media prior to the opening of a new movie that seems to be pretty popular with the kids. May the coverage be with you.
Connect for Health Colorado reports an all time high enrollment with more than 145,000 Coloradans enrolling in coverage between November 1 and December 15 (including over 116,000 enrolled in QHPs). On December 22 Connect for Health Colorado chose to extend its deadline for a second time to December 26. This followed an initial 48-hour deadline extension that generated increased interest and a snowstorm on December 17, which affected the ability of consumers to enroll. Based on the later deadline, additional enrollments for January 1 will likely be reported in the coming weeks.
Access Health CT (AHCT) has reported higher enrollment rates for 2016 over previous open enrollment periods. As of January 5 there are 104,363 consumers enrolled in a QHP. Of these customers, 22 percent are new to the marketplace.
AHCT has focused on reaching consumers on their electronic devices and in their communities. Through its “Get Covered CT” campaign (also available in Spanish at “Asegurate CT”), individuals can share their coverage status through text messages and opt in to text and/or email messages tailored to the registrant. AHCT has also increased the number of community events, called “Community Chats” which are hosted at places of worship, libraries, and schools in the communities where the uninsured work and live. AHCT reports it has developed 100 new organizational contacts through attendees at these chats.
District of Columbia
The DC Health Benefit Exchange Authority publicly releases enrollment information at its monthly Executive Board meetings. The latest numbers were released January 13. Since opening for business October 1, 2013 through January 11, 2016, 31,188 people have enrolled in individual market coverage through DC Health Link; 25,657 employees have obtained Small Business Health Options Program or SHOP coverage through DC Health Link; and 144,329 people have received Medicaid eligibility determinations through DC Health Link. DC Health Link also reported that to date 3,831 new customers have enrolled for 2016 coverage; 2,594 renewing customers had changed their health plans for 2016; and that DC Health Link had auto-renewed 14,108 individual market customers for 2016 coverage.
DC Health Link has focused on outreach events that attract the District’s young adult population. DC Health Link had major enrollment efforts tied in with the recent release of the newest Star Wars movie and on December 15 the SBM hosted a coverage “café crawl”, where teams of assisters and navigators with internet-ready laptops were stationed at three of DC’s most popular coffee shops..
On December 18, Your Health Idaho reported that over 93,000 individuals had selected a QHP for 2016 through Your Health Idaho. This is a significant increase over the approximately 86,000 Idahoans enrolled in coverage for 2015. Your Health Idaho continues to strengthen its partnership with agents and brokers including the statewide enrollment event “Super Sign-Up Saturday” on January 16th.
Enrollment continues through Kentucky’s marketplace, kynect, although newly inaugurated Governor Bevin may propose changes. In a recent report, the United Health Foundation moved Kentucky up three spots in its annual ranking of state health – from 47th to 44th. A significant factor in the move was increased access to insurance, over the past two years the report found a 24 percent decrease in the uninsured across Kentucky. kynect has been continuing to use their successful “kynect stores,” which had extended hours over the holiday season.
Similar to its counterpart in DC, the Maryland Health Connection (MHC) has also decided to increase its focus on the sometimes hard to reach “young invincible” population. The state launched the #HealthYeah campaign that stresses free, local, in-person enrollment assistance and financial assistance for most enrollees.
MHC is also trying to reach other more difficult to engage populations. Outreach activities include 16 weekend enrollment fairs, including on December 13 in Baltimore where Meredith Hurston, who blogs on health care resources geared to the African-American community hosted a live Periscope video stream / Q&A for consumers. Other events include a statewide “Library Enrollment Day” on January 9 where enrollment navigators staffed public libraries; a Hispanic-oriented enrollment fair on January 13 which included radio station “El Zol,” and “Super Health Sunday” on January 24 where navigators will be on hand to assist with enrollments at several predominantly black churches.
Enrollment numbers demonstrate the success of these efforts. As of December 28, 71,055 Marylanders have enrolled in a new Qualified Health Plan, and an additional 79,238 people have already renewed their plan for 2016.
As of January 1, the Massachusetts Health Connector reported a total enrollment of 189,700 individuals, with more than 27,600 representing enrollees new to the marketplace. Reports from the state highlight that the open enrollment period has been smooth, with low wait times for its call center (average of 9 seconds) and an increased availability of in-person assistance.
For this open enrollment period, the Connector focused its outreach and education campaign on 10 priority communities with higher rates of uninsured residents. Messaging was delivered predominantly through spots on Hispanic TV and radio, as well as a significant investment in digital outreach, and was focused on benefits of coverage and the availability of support to both pick the right plan and complete the application.
Enrollment figures released by MNsure on January 4 showed 67,680 Minnesotans enrolled in a qualified health plan(QHP) by December 28. Of those QHP enrollees, approximately 40 percent are new to the exchange. This is in comparison to last year, where total QHP enrollment was 60,092 after the end of OE2.
Minnesota’s broker enrollment center initiative also continues to gain momentum in its second year of operation. To date, the 20 walk-in broker enrollment centers statewide have enrolled more than 3,160 Minnesotans in a QHP. That’s more than twice the number of QHP enrollments by the same group compared to this time last year. MNsure offers matching marketing funds to these brokers to help promote their business across the state, and uses them for earned media opportunities where appropriate.
beWellnm hit the ground running on November 1 with a robust schedule of events, a new consumer centric website, and advertising that targeted the rural and remote communities in the state. The exchange has hosted more than 249 outreach activities with 15,671 attendees since the launch of open enrollment.
Exchange outreach efforts have focused on reaching the Hispanic/Latino, Native American, and urban and rural communities by hosting scheduled events at Hispanic marketplace locations, in outlying rural communities, urban centers and pueblo communities. Additional efforts included bilingual town hall radio calls that feature a local celebrity who is highly regarded by the community, partnering with advocacy groups that work with the hard to reach communities, as well as presentations to civic organizations. beWellnm engaged outreach partners located throughout the state to focus on their communities and identified unique language and messaging to help them understand the benefits of having insurance and moving them to enrollment.
These efforts have led to a 47 percent increase of traffic to the call center from the first week of December to two weeks prior to the December 15 deadline. Additionally, the exchange moved from a referral – only call center to a certified application counselor or CAC certified call center, which may have increased enrollment and provided a better consumer experience. As of December 26, 46,816 individuals are enrolled for 2016 coverage.
In recent weeks, New York State of Health has reported significant activity on its website (43 million page views, 1.8 million individuals using the anonymous shopping tool) and at its call center (averaging over 34,000 calls a day leading up to December 15). Based on this interest, the state pushed back its deadline for January enrollment from December 15 to December 19.
New to the market this year is the state’s Basic Health Plan, called the Essential Health Plan, which provides low- to almost no-cost coverage to individuals with incomes between 138% and 200% of the federal poverty level. New York State of Health has developed a marketing campaign promoting the plan, with a digital spokesperson named “Essie”, targeted at young New York residents.
On January 6, Health Source RI reported that 34,627 individuals have enrolled in a QHP for 2016. Of these enrollees, 4,462 represent individuals who are new this year.
Rhode Island extended its January enrollment deadline to December 29 to accommodate the surge of calls received by the SBM leading up to its previous December 23 deadline. To help drive enrollment, HealthSource RI has continued to offer a significant number of in-person assistance events (with over 20 scheduled for OEIII), including an Enrollment Fair with all the participating insurers that took place on December 1.
In mid-December, Vermont Health Connect launched a new plan comparison feature on its website that will allow potential enrollees to review costs across different health care plans. The tool allows individuals to compare the costs of major medical procedures, premiums, and out-of-pocket costs in various plans and is designed to give consumers an educated look into their potential health care spending for 2016. Vermont Health Connect is hopeful the tool will help Vermonters make more informed choices when selecting a plan for the upcoming year.
As of January 6, the Washington Healthplan Finder reported that it had 173,947 individuals enrolled in QHP coverage for January 1. During OE3, Washington Healthplan Finder has worked on its partnerships with small local businesses and the broker community through its events, storefront, and referrals.
The exchange has been particularly successful at reaching the young, “invisible” population. More the 50,000 residents under the age of 35 signed up for insurance through the exchange in the first weeks of open enrollment, representing a 66 percent increase in young adult enrollment over last year.
NASHP will continue to update the progress during this open enrollment period as we move towards the January 31 deadline. We encourage you to check back on the blog for the latest.