Analysis Spurs Changes in Covered California Outreach Strategy

Greater effort will be made to enroll people of color in the state’s health insurance exchange when the second enrollment period starts Nov. 15, according to Covered California board members.

The Covered California board last week, after examining enrollment deficiencies during the first open enrollment period, committed more resources and attention to two main efforts for the next open enrollment period — beefing up the online component of enrollment and working for better minority enrollment, particularly among the black and Latino populations.

Reviewing newly available web data at the June 19 meeting, the five-member board found the Covered California rollout lacked strong outreach to minorities. The board members agreed to conduct the next enrollment period with greater awareness of geographic regions and the demographics served in each one.  

The next open enrollment period is Nov. 15 to Feb. 15, 2015.

Special attention to multilingual support and counseling is needed, according to information presented to the board by the exchange staff. The staff report said strengthening online enrollment structure is vital to casting a wider net to reach more California.

“This is a timely analysis that underscores the importance of review,” said board member Kim Belshé. “We need to remind folks that the California landscape is not the same as other states and our regulatory construct is different.”

According to Leesa Tori, interim director of plan management for the exchange, an organizational effort as large in scope as Covered California is going to have its share of missteps. The sheer volume of people enrolled led to many difficulties, she said. “We’ve learned some things. We are never going to enroll 1.5 million people in one open enrollment again,” Tori said.

Since Covered California’s launch in October, 1.4 million people have enrolled. Insurers with the largest share of the market reported that  80% of premiums have been paid.

Most enrollees fall into the income category between 151% and 200 % of the federal poverty level. Of that group, 40% self-enrolled online and 39% went through agents.

The staff analysis comes on the heels of a May report by the Public Policy Institute of California that found Latinos were underrepresented in exchange enrollment, in spite of their large share of the state’s uninsured population.

State Sen. Norma Torres (D-Pomona), introduced a bill, SB 972, to make the skills and makeup of the board more diverse. It has passed both houses and is awaiting the governor’s approval.

The exchange board reviewed the success of the California State University in signing up its uninsured students and will consider whether or not to adopt a similar outreach model.

The CSU system saw a reduction in uninsured students during open enrollment – from 25% to 10% uninsured.

“As much progress as we’ve made in three and a half years, we are still really at the very beginning,” said board chair Diana Dooley. “We are in transformational change that is going to take a long time.”

Concerns about operational issues in the next enrollment period were also raised. An initiative on the November ballot would give the state insurance commissioner authority to reject health insurance increases deemed excessive. Since California health insurance is overseen by two regulators — the California Department of Insurance and the California Department of Managed Healthcare — such a regulation could create impediments to timely enrollment of new participants, according to Covered California staff.

Board members and staffers said there were too many unknowns about rate regulation to get a solid understanding of whether it would be harmful or beneficial for Covered California. Board members questioned the impact it would have on consumers with subsidies and whether approval for rates could delay enrollment processes.

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