By BETSY TAYLOR
Enrollment through healthcare.gov — the online marketplace about three dozen states use for many people to gain health insurance through the Affordable Care Act — will be open for 45 days this fall, a window shortened by about half from previous years. And the government's advertising and promotion budget has been cut to a fraction of prior year spending.
Maggie Ward, right, serves as project director on an insurance navigation grant for Ascension's Via Christi Health. Here, she consults with a colleague in the Via Christi Cancer Outreach and Risk Assessment program offices in Wichita, Kan., where an insurance navigator office is also located.
In light of these challenges, several CHA members underscored that health care access and insurance coverage for all remain their top priorities as they gear up for the open enrollment period, which begins Nov. 1.
CHA members are spreading the word of that shortened enrollment window, running until Dec. 15, through communications with employees, community organizations and patients. They're also sharing that healthcare.gov will have scheduled shutdown periods, including overnight on Nov. 1 and from midnight until noon each Sunday except for Dec. 10. The public won't be able to enroll online during the shutdowns. Some in the ministry called the shortened enrollment period, and a greatly slashed budget for open enrollment advertising, a disappointment.
While on the national stage there have been multiple, unsuccessful attempts to repeal and replace the ACA, CHA members said they are committed to helping the uninsured and underinsured sign up for insurance plans during the open enrollment period. Some CHA members are in the third year of three-year grants from the Centers for Medicare and Medicaid Services to fund insurance navigator positions and otherwise support insurance sign-up efforts. They said they have resources similar to or the same as what they've had in recent years.
Englewood, Colo.-based Catholic Health Initiatives leaders said their messaging encourages people to review their health insurance plan every year, to make sure their coverage meets their needs and to check on changes in price.
Laura Krausa, CHI's system director for advocacy, said some states operating their own insurance exchanges will have open enrollment for a longer window than the federal insurance exchange. CHI is tailoring its messages about enrollment deadlines accordingly by state. The system uses internal and external electronic communications and social media to reach its audiences.
"There is definitely a heightened sense of urgency," said Annemarie Hartwig, CHI's vice president of payer strategy and operations.
Ministry systems said they are being strategic about where they are concentrating resources. As an example, due to the shortened open enrollment period this year, Ascension's two community health ministries in Texas are using their grant to temporarily increase their navigator staff by 50 percent, to 24 total navigators.
Sr. Ellen Kron, DC, vice president of community health ministries for St. Louis-based Ascension, said the system is in the third year of a three-year CMS grant to facilitate insurance enrollment under the ACA at Daughters of Charity Services of San Antonio, which provides health and social services; and Centro San Vicente, a federally qualified health center in El Paso, Texas.
She said the navigator programs in San Antonio and El Paso serve an area of 2.7 million people, and it is estimated that 19 percent of that population is uninsured.
Via Christi Health, Ascension's Kansas ministry, is also in the third year of a three-year CMS grant. The system said basic consumer education about paying for and using health insurance continues as part of its effort to increase the numbers of insured. Maggie Ward, project director on the insurance navigation grant, said outreach occurs prior to open enrollment at places like the Kansas State Fair. When open enrollment begins, navigators working in multiple locations in the state helping people enroll in insurance coverage.
Ward said health insurance coverage improves access. She said she knows of patients insured under the ACA expansion who now get mammograms and colonoscopies or are "seeing doctors when they haven't seen them in years."
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