1 connecting millions of americans with health coverage: the 2013-2014 opportunity
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Connecting Millions of Americans with
Health Coverage: The 2013-2014
Opportunity
Delivering on the promise…
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…of affordable health coverage for
millions of Americans…
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…starts now.
259 days until October 1, 2013.
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Health Coverage in 2014
MedicaidExchange
(“Marketplace”) with Tax Credits
Exchange or Private Plan
Income as a percent of the federal poverty level
0 133 400+
Coverage Options for Adults without Medicare or Employer-Based Coverage
An Opportunity for a Complete Continuum of Coverage
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The Enrollment Opportunity
All States Expand Medicaid 41% 37% 9% 13%
Eligible for Medicaid ExpansionEligible for Exchange with SubsidiesEligible for Exchange without SubsidiesNot Eligible Due to Immigration Status
49 Million Total Nonelderly Uninsured
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Enrollment isn’t a snap
ProgramPercent of Eligible People
Enrolled
Adult Medicaid, national average 62%
Subsidized Medicare for low-income seniors 33%
Medicare Rx benefit low-income subsidy, 2009* 40%
Unemployment benefits 72-83%
Earned income tax credit 80-86%
SNAP (food stamps) 54-71%
* Does not include populations automatically enrolled in the low-income subsidy.
Take-up in optional public benefit programs
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Children’s Health Coverage
•Mainly private sector outreach via RWJF’s Covering Kids & Families project • $141 million between
1997-2006• 85% of eligible children
now enrolled
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Medicare Part D• Active leadership from
White House and Administration• $1.5 billion
administrative fund• 22.5 million enrolled
during first open enrollment (Nov. 2005 – May 2006)
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Limited Public Awareness
The majority of uninsured Americans don’t know the health reform law will help them
78%
of the uninsured don’t know about the new health insurance exchanges
83% of people who could be eligible for the new Medicaid expansion don’t know about it
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Enroll America
We will continue:
• Building coalitions• Sharing best practices
Coming soon: a major enrollment campaign, using cutting-edge engagement strategies
Our MissionEnsure that all Americans get enrolled – and stay enrolled – in health coverage.
How will people APPLY for coverage?• Online? By phone? On paper?• Available in the right languages?• Written in plain language?• Accessible for people with
disabilities?
What SYSTEMS will need to be developed to make it possible?• Consumer-friendly “front end”• “Back end” systems that are
coordinated between Medicaid, the Exchange, CHIP, other programs
• Connections with data that can help prove eligibility
What ASSISTANCE will they need?• Understanding the application and
eligibility process• Counseling on tax credit decisions• Help choosing a plan and learning
how to use it
How can people KEEP coverage once they’ve got it?• Data-driven renewal• No need to return forms• Opportunities to update
information and change coverage as circumstances change
Sampling of Partners
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Working together: We all play a role in a
successful enrollment effortInsurers
Hospital
s
Consumer
groups
Retaile
rs
Community Health Centers
Grassroots volunteers
Civic Groups
Labor
Communiti
es of Color
Faith-based
groups
Business
Drug Companies
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Race/Ethnicity Percent of Uninsured
Uninsured Rate
White (non-Hispanic) 45% 13%
Black (non-Hispanic) 15% 21%
Hispanic 32% 32%
Asian/Pacific Islander 5% 18%
American Indian/Alaska Native 1% 27%
Two or More Races 2% 15%
A Diverse Group
Source: Kaiser Commission on Medicaid and the Uninsured, October 2012
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CA
TX
FL
NYGA
ILNCOHPANJ
MIAZ
VATN
WAIN
MOSCLAMD
ALCO
Rest of the US
Two-thirds of the uninsured live in 12 states
CATXFLNYGAILNCOHPANJMIAZ
Where are the
Uninsured?
What kind of exchange are states likely to have?
Alaska: [119,700]Hawaii: [90,900]
Partnership exchange likely
State exchange likely
Rejected state based exchange1
7 million
6.1 million
3.9 million
2.7 million
1.9 million
1.8 million
1.6 million
1.5 million
1.3 million 1.2 million
1.2 million
1.2 million
1 million
927,700
852,600
526,300
550,700733,000
655,000
855,600
838,100
242,400
341,200
636,200
350,000
214,800
503,800
459,100
104,500
73,800
87,500
686,600*
160,300
388,300544,800
633,000*
880,200
260,200
417,000
759,000
124,70057,800
130,800
104,600
737,000*
320,000*
119,000378,000*
Note: Numbers provided are non-elderly uninsured, based on the Census Bureau’s Current Population Survey (2010-2011 two-year merge). Asterisked states have obtained HHS’s conditional approval for their state-based exchange.1States that have rejected a state based exchange have until February 15, 2013 to decide whether to operate a partnership exchange or default to a federally facilitated exchange .
As of January 16, 2013
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Building an Effective CampaignGrassroots field efforts
Creative use of social media
National and local surrogates
Education & engagement through partner entities with
direct reach to target populations
Earned media events and Activities in communities to
magnify messaging
Enrollment assistance by
trusted community
sources
Paid advertising on TV, radio
online, and in print media
Paid advertising on TV, radio, online,
and in print media
Data, Analytics,
Microtargeting
Constituency engagement
Strategic Partnerships
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Grounded in Research
(1)The most effective messages to reach target groups
(2)The best messengers for these communications
(3)The best ways to deliver these messages (e.g. television, radio, social media, etc.)?
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Research Design
National Survey
• Fielded in October• 1,800 adults, oversamples
of uninsured, low-income, Latinos, African Americans, young adults
• Explore –by target group—motivations to enroll, barriers, trusted messengers, communications methods, awareness and attitudes toward ACA
10 Focus Groups
• November 13-18 in Philadelphia, Columbus, San Antonio, and Miami
• Groups include Latinos (English- and Spanish-speaking), African Americans, young adults, parents (low and moderate income), childless adults (low and moderate income)
• Test branding and messages
Some Key Findings
1. Universal value of insurance2. Cost and affordability are biggest barriers3. Universal messages surrounding exchanges4. Deep skepticism among consumers
• Previous bad experience
• Too good to be true
5. Insurance is confusing6. Latinos vastly overrepresented among uninsured7. Everyone wants help enrolling in coverage
Targeting Messages
•The leading perceived benefit of coverage across populations
Financial Security & Peace of Mind
•A key message for women
Prevention
•Resonated most with men and young adults in some states
Protection from Financial Ruin or Injury
•Resonated with African Americans, Latinos, and Medicaid eligible
Access To Care
•Key message for low income, Medicaid eligible
Low cost or free health insurance coverage
Help, I Need Somebody!
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• Figuring out if they qualify for financial help (55%)• Finding the best plan for them (52%)
What Kind?
• Someone from your state whose job it is to help people with these new options (45%)• Family member (37%), your doctor or nurse (36%), someone from a health insurance
company (35%)• Which family member? Spouse (42%) or mom (20%)
From Whom?
• In-person (75%), telephone (33%), email (20%), online chat (9%)
How?
• Insurance agent or broker’s office (29%), family member or friend’s home (27%), clinic or doctor’s office (22%), Medicaid office (21%).
Where?
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Public Education Resources
More Information On:
• Exchange branding research
• Public opinion polling
• Statewide marketing and outreach plans
