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Enroll America Gears Up for Coverage Expansion Effort

By John Reichard, CQ HealthBeat Editor

November 19, 2012 -- Those spearheading a broad-based, privately funded educational campaign to enroll the uninsured in health plans as part of the health care overhaul are in the closing stages of pinpointing what messages they will use and which audiences the effort will target.

The campaign's goal is to fully develop its strategy by year's end and to launch in mid-2013, in time for the Oct. 1 start of the open enrollment period in the new state insurance exchanges.

Although previous expansions of such government coverage programs as Medicaid and the Children's Health Insurance Programs signed up people at a much slower pace than expected, officials with this initiative, called Enroll America, hope they will be able to move far faster. That's because of the unprecedented size of the effort and the sweeping nature of the coverage it will be touting.

Rachel Klein, executive director of Enroll America, said in a recent interview that it has 55 partnering groups and expects to add additional ones now that the election is over and full implementation is a go. One group it is waiting to hear from is America's Health Insurance Plans (AHIP), which provided seed money for the effort.

"We've been keeping AHIP updated about our work, and Karen Ignagni felt that the best time to consider AHIP's further involvement would be after the 2012 elections," Klein said, referring to the lobby group's president.

But there are big challenges. One is the uncertainty about where Medicaid will be expanded because state-by-state battles involving governors, legislatures and health care lobbies—including hospitals—will play out over a number of months and not be resolved quickly. "We're looking to see where it makes sense for us to do our work," Klein said.

Another is the huge size of the population the campaign aims to reach. Klein said that according to one survey, 78 percent of the nation's uninsured aren't aware that there is going to be coverage available for them. Enroll America estimates that up to 40 million uninsured people will be eligible for coverage through expansion of Medicaid and subsidies to buy coverage in insurance exchanges.

"That is really a significant information challenge," she said. "I think it's hard to overestimate the amount of work that will be needed in order to get the word out."

But the 55 organizations committed to the enrollment effort results in a diverse effort and a breadth of involvement that will be "groundbreaking," she said. Groups include Families USA, the American Hospital Association, AARP, the United Way, the Catholic Health Association, Catholic Charities USA, Aetna, Kaiser Permanente, the NAACP, SEIU, CVS Caremark and the National Association of Community Health Centers.

Klein said that hospitals and community health centers will be particularly effective in helping to enroll the uninsured and their families because of the large number of people they treat who do not have coverage.

The fact that help is available to so many also will help, she added.

Expansions in the past were much more limited. "For example, if you look at the Children's Health Insurance Program, it was for kids, and for kids in a certain income bracket. And so with this new coverage we'll be able to say that there really is something for everybody in a lot of the states."

The multimillion dollar campaign will include paid advertising on TV and radio.

But hands-on help will be needed as a follow-up to such messages. "I think in-person assistance is going to be very crucial," she said. She said the campaign is working with its partners now to determine the scope and nature of those in-person efforts.

"We are right now actively developing a message for our public information campaign that we intend to launch in the middle of next year," Klein said.

"We have just finished a nationally representative survey and some focus groups that will help us identify a message that will reach the broadest number of uninsured individuals. We are in the process of sifting through that data identifying the message."

The questions the campaign will be seeking to answer as part of that process are "who are the different target populations? Where do they live? What are the kinds of concerns that they have about being uninsured? What are the key motivators that will help them seek out new health coverage? And how can we best and most effectively and efficiently reach them?" Klein said.

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