Affordable Care Act – Got Questions ?

Beginning in January 2014, millions of Californians will be newly eligible for health insurance coverage under the Affordable Care Act (ACA). Many will need help understanding, accessing, and using these benefits. The California HealthCare Foundation and Community Health Councils have released a new report On the Path to Enrollment: Getting Californians Covered Under the ACA that details the outreach, enrollment, and assistance programs required under the ACA and efforts to implement consumer support in California. Outreach organizations can use the report to see where their work falls within the framework and the funding opportunities available. The report educates the broader community on how California will provide outreach, enrollment, and problem-solving assistance as the state implements the ACA.

“California’s diverse population requires a mix of consumer support tools to help resolve enrollment barriers such as cultural and linguistic access, low levels of health literacy, and the general difficulties of enrolling in public programs and health insurance,” says CHC policy director Sonya Vasquez, MSW, a co-author of the report with Fatima Morales, MSW, and Lark Galloway-Gilliam, MPA, of Community Health Councils. “California is establishing a network of community-based services to outreach to consumers, provide information on enrollment and coverage options, and offer problem-solving assistance for those already insured. The success of these strategies will depend upon community organizations and others stepping forward to play a role.”

The state expects to reach 39 million Californians through a statewide marketing and outreach campaign and a Community Mobilization Program to raise awareness among consumers and small businesses about coverage options. California will be using a variety of tools including television, radio, magazine and newspaper advertising; social media, email, and text messaging; a website and customer service center. On the Path to Enrollment: Getting Californians Covered Under the ACA describes the timeline for the campaigns, the cycles for the outreach and education grant program, who is eligible, and their roles and responsibilities.

Help applying for, changing, renewing, or discontinuing health coverage will be available through enrollment assistance. States like California that have their own marketplaces are required by the ACA to have Navigator and Certified Application Counselors as part of their enrollment efforts, and may use Non-Navigator assistance personnel, insurance agents, and brokers to assist in enrollment. California is integrating its Navigator and Non-Navigator Assistance programs under Covered California. The report compares the different elements in the two programs, eligible entities and qualifications, training and certification, compensation, and populations served.

In addition to ensuring that consumers know about and receive help applying for coverage, the ACA requires states to assist consumers with problems. Consumers can get in-depth support when issues arise with accessing care or using healthcare coverage. This help could include filing a grievance or appealing eligibility. The report reviews California’s consumer assistance programs, the populations served, and assistance available as well as providing contact information.

On the Path to Enrollment: Getting Californians Covered Under the ACA is a publication of the California HealthCare Foundation prepared by Community Health Councils.

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