States’ Restrictions on ACA Implementation Hinder Access to Coverage

Community health centers across the country are waging intensive efforts to find and enroll eligible and uninsured patients and community residents, but are hampered by states resistant to healthcare reform, according to the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services.

The study, “Assessing the Potential Impact of State Policies on Community Health Centers’ Outreach and Enrollment Activities,” is the first to examine efforts to find and enroll uninsured people, many of whom are living in rural and urban communities that face high poverty rates, elevated health risks and a shortage of primary healthcare. Researchers examined the early outreach and enrollment efforts of 606 community health centers across the United States. They compared health center outreach and enrollment in the 21 states and the District of Columbia that have fully embraced health reform to health centers in nine states (heavily concentrated in the South and Midwest) that have resisted or rejected key parts of the ACA. Restrictive states were defined as those that had both rejected an expansion of Medicaid and adopted Navigator laws which make it harder to provide assistance to the uninsured.

Among the report’s top findings:

  • U.S. health centers are conducting outreach through expanded on-site and community assistance and new partnerships with colleges and universities and programs serving young adults in need of coverage.
  • In addition to assistance with both paper and online applications, 60 percent of health centers reported that as of early October, when enrollment assistance was just getting under way, they were helping with documentation efforts as well.
  • Community health centers in the restrictive states had significantly more limited outreach and enrollment resources and had significantly fewer enrollment staff (an average of three full-time enrollment staff in restrictive states compared to six in full implementation states.)
  • Health centers in restrictive states were significantly less likely than those in full implementation states (59 percent compared to 79 percent) to be assessing patient eligibility for insurance coverage.
  • In restrictive states, nearly one in six health center leaders expected at least half of their patients to remain uninsured. In full implementation states, only 2 percent said they believed that half or more of their patients would remain uninsured.

Source: GW Public Health (NIH), January 14, 2014

Managed Medicare and Medicaid Factbook: 2014

Managed Medicare and Medicaid Factbook: 2014 provides practical data and strategic information and convenient access to up-to-date enrollment data so readers can easily evaluate market share, make plan-by-plan or state-by-state comparisons, identify opportunities and develop strategies.

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