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HHS Plans Outreach to Teach Newly Insured How to Use Benefits

By Rebecca Adams, CQ HealthBeat Associate Editor

May 15, 2014 -- The Department of Health and Human Services (HHS) is preparing to launch a national campaign this summer to help newly insured people understand how to use their benefits, according to a federal official who spoke at a forum on women's health at the nonpartisan Kaiser Family Foundation.

Inside the agency, officials refer to the effort as the "You got covered, so now what?" initiative, said Cara James, the director of the Office of Minority Health.

The work is important because more than 75 million people have low health literacy and have difficulty understanding basic health information, according to a study cited by federal officials.

"It's badly needed," said Alina Salganicoff, the Kaiser Family Foundation vice president and director of women's health policy, at the briefing.

Panelists also discussed findings from a Kaiser survey on health coverage that polled 3,015 women and 700 men between the ages of 18 and 64.

People who are gaining coverage through the health care law (PL 111-148, PL 111-152) may have never had insurance before, or only have a very weak understanding of how coverage works. They may not understand such basic questions as how to pay premiums to renew coverage, what a deductible is or how to find a doctor.

The survey released at the Kaiser briefing shows that 16 percent of the uninsured women who were interviewed and 3 percent of those on Medicaid said the place that they usually get care is the emergency room.

James highlighted the high use of emergency rooms by the uninsured as one example of a behavior that administration officials want to change as people start using their new benefits.

Signing people up for benefits was just the first step in lowering the uninsured rate. Helping people understand the importance of retaining coverage—such as through paying for premiums so people do not lose their individual market plans – is a big concern for insurers and state and federal officials.

The HHS effort would build on a pilot program being tested now in four states.

Obama administration officials created an 18-page booklet in English and Spanish that addresses questions such as "What is my copayment?" and steps to make an appointment. They also produced 10 videos with titles like "My New Health Plan" and "Finding a Provider."

The administration will distribute the information partly through networks of community groups, Head Start agencies and enrollment assisters, said James.

The survey that was presented at the briefing will serve as a baseline that can help policymakers understand the health care law's effects, particularly on women.

About 55 percent of women said they had been contacted by a collection agency in the past 12 months because of a medical bill and 45 percent said they had difficulties paying for basic needs such as food or housing because of medical care.

About 20 percent of women said they put off or postponed preventive services—which some experts believe can lower health spending overall—because of the cost. About 32 percent of women said they were currently paying off medical bills, compared to 22 percent of men.

The survey showed that coverage is changing. The leading source of coverage for young women was their parents' coverage, with about 45 percent of the 18- to 25-year-olds polled saying they are on their parents' plan. Only about 8 percent of women in that age range had their own employer-sponsored insurance. About 19 percent of people in that age range were uninsured.

The survey was conducted from Sept. 19, 2013, through Nov. 21, 2013. The open enrollment period for the new marketplaces began on Oct. 1. The error rate for the sample of women was 2.9 percentage points and for the sample of men was 4.3 percentage points.

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