Good News, Bad News For The ACA
There is a lot of good news about the Affordable Care Act. It has survived Supreme Court review and a nearly white-hot hostility from its opponents. It is well on its way toward being implemented nearly whole starting on Oct. 1, when Covered California and the other state exchanges open for business.
In California, the ACA also has fairly strong support. A recent Field Poll said 53% of residents support healthcare reform, compared to only 38% opposed. Perhaps more importantly, more than 60% of those under the age of 30 support the law. This is crucial, given enrollment by this constituency in individual health plans purchased through Covered California will help keep premiums down for every age group.
At the same time, there is still an elephant in the room regarding ACA: Few people actually know how it will function. For instance, 57% of those Field Poll respondents said they thought it would cause Medicare enrollees to lose their benefits. Fifty-four percent thought they would be forced to change their own coverage.
When such misconceptions are commonplace, it becomes more challenging to make outreach to those communities who lack health insurance – such as Latinos – work. If there is a specific mindset that the ACA is an exercise in taking things away from people, they will be understandably skeptical about the advantages it offers.
Moreover, a steady stream of disinformation about the ACA (e.g., death panels, higher taxes) has been accompanied by a wholesale attempt at making sure actual facts are not disseminated. In Missouri for example, a ballot initiative blocked the state from setting up its exchange without the approval of the GOP-controlled Legislature and voters first. Not even the state's insurance commissioner is talking. As a result, Missourians will learn of the premiums they will pay in the exchange about two weeks before it opens for business. Don't expect a stampede of applicants.
Such a lack of interest would be tragic in California, where some 7 million people lack insurance – a figure pushed upward nearly 20% by the job losses that accompanied the Great Recession. And some ethnic groups are woefully underinsured: Nearly a third of the state's Latinos lack insurance, compared to just 14% of whites. Language and cultural barriers can serve as formidable obstacles in getting the word out to these groups that health insurance is obtainable.
Aside from an advertising blitz coming soon from Covered California, the state is currently wrapping up training of more than 2,000 navigators whose role will be to educate Californians about the Affordable Care Act. They have a formidable task ahead of them: They would have to contact more than 3,000 people apiece to reach every person who lacks insurance to do a thorough job. And, they cannot actually do any enrollments into Covered California. That group of people – which includes insurance agents and is 10 times the number of navigators – will not receive their training until next month.
Health policy experts say that the success of ACA hinges on how quickly enrollment is achieved. It will be a big challenge for those navigators and enrollment counselors to get a substantial number of Californians to participate. Let's hope they hit the ground running.
To be successful, though, every healthcare professional and organization needs to support this outreach and education effort. At COPE Health Solutions, we have prepared consumer-friendly communications for our clients to use to help their patients and communities understand what the ACA does and how to connect to Covered California. This is something we can all do.
Jim Lott is executive vice president of talent development and external affairs for COPE Health Solutions. He is a member of the Payers & Providers editorial board.
