The celebration is nearly over and the administration has basked long enough in the glory of hitting 8 million enrollments, a million more than the target they set. The numbers are impressive, but so is the challenge ahead for the administration – ensuring that this next phase of ACA implementation goes as smoothly as possible. The performance of the administration in this phase is going to have a huge effect on the outreach and enrollment efforts for the upcoming open enrollment period.
When ACA was being rolled out amid challenges from states and opposition, the closest case study that it could follow was of CHIP implementation. The Children’s Health Insurance Program faced similar challenges and required close coordination between states and federal authorities over laws and connected challenges. Resistance from governing authorities marred the initial CHIP implementation, and it only picked up after the initial challenges were sorted. The same was exactly repeated while implementation of ACA was underway, and similar strategies resulted in a better movement of the law. Now, we are in the second stage of ACA implementation and a lot can be learned from what CHIP implementation went through in its second phase. With November 15 quickly approaching, the administration has limited time on hand to ensure that the second enrollment is equally successful and disenrollment is kept in check.
A study on CHIP implementation, with nearly 20 years of extensive efforts on outreach and enrollments, can easily list down the major pain areas that the administration might have to encounter in the coming months. Let’s take a look at the specific efforts that CHIP implementation utilized, and how it perfectly applies to ACA implementation.
• Communication with underprivileged communities – A major push needs to be made toward communicating with communities that are hard to reach and underprivileged. Through specific messages that address the concerns of these communities, the administration can reach through and deliver their intentions. These efforts would encourage these minorities to align with the law and stay motivated to enroll whenever there is a life-changing event. In CHIP’s implementation, a similar effort resulted in success for these communities, and the same can be repeated for ACA.
• Give complete support to those enrolled in the first enrollment period – For those covered in the first enrollment period, an effort for delivering positive experience should be made. This effort would drive satisfaction with the program and reduce the chances of people moving for disenrollment. An added advantage would be of positive publicity from those happily enrolled for people who are still not enrolled with the system due to deep-laid concerns. A similar effort post CHIP implementation ensured that disenrollment was minimized and the program got ongoing traction across all channels.
• Utilize strategic reliance on all platforms for enrollment – While web based enrollment is central to the whole ACA program, the administration would be better off by devoting equal energy to traditional enrollment methods. These traditional methods, in CHIP’s case, have proven successful for communities that are not technically equipped. ACA, in its initial stages, has benefitted from traditional methods, such as paper applications, and the administration should continue to give attention to these methods even in this phase.
• Make re-enrollment a breeze for eligible families – The importance of re-enrollment can be easily extracted from CHIP’s case study. By making re-enrollment simple, CHIP increased its chances of retention of coverage, and a similar advantage can be utilized by ACA.
• Remove the initial challenges newly insured are facing – In this phase, a lot of individuals who recently got insurance are expressing their unhappiness with the coverage that insurance provides. The problems range from cost to narrowing networks, and the administration can learn from CHIP implementation about reducing concerns and providing a positive experience to the recently insured.
While ACA has taken a few good pages from CHIP’s success book, the above lessons will take the administration closer to ensuring continuing success across all verticals. An example of a similar implementation can be seen in California, where the administration observed that in their successful run on the state exchange, it observed Latinos to be underrepresented in the enrollment numbers. Their specific moves to address this community brought outstanding results, with Latino enrollment jumping by nearly 50 percent.
The years of effort and strategizing that went into CHIP’s implementation was crucial for its success, and with ACA closely resembling the journey of CHIP in its initial stages, similar outreach and retention efforts should deliver similar outstanding results for ACA administration. No matter how successful the law is on paper, the key to delivering benefits throughout is perfect implementation, as CHIP implementation has portrayed in the past.