Open Enrollment Period Begins November 1 for Marketplace Insurance Coverage

November 04, 2016|12:19 p.m.| Anna Bartels

Health insurance coverage is important to ensuring access to care by minimizing financial barriers to the timely use of health services. Central to the mission of public health, health insurance coverage helps people access the right care at the right time, and prevents and controls disease and injury. Marketplace insurance plans cover preventive health services, essential health benefits, and ensure coverage for individuals with pre-existing conditions, making health insurance enrollment a critical public health strategy.

HHS estimates that 13.8 million Americans will sign up for health insurance coverage during the 2016 open enrollment period, which begins on Nov. 1. This is a projected increase of 1.1 million people from 2015. Further, recent analysis by the Kaiser Family Foundation estimates that 43 percent of presently uninsured Americans are eligible for coverage under Medicaid (6.4 million Americans) or marketplace subsidies (5.3 million Americans).

State and territorial health departments are well-positioned to raise awareness of resources and enrollment deadlines to expand access to health insurance coverage. For instance, Enroll America reported that, although consumers have different preferences about how they receive information and seek assistance, most consumer groups consider state and local health agencies to be a preferred and trusted messenger for providing health insurance information.

Seventeen percent of local health departments serve in an official capacity as health insurance navigators and 43 percent provide informal assistance. Meanwhile, 38 percent of states and territories conduct outreach and enrollment activities. State and local health agencies engage communities by hosting community enrollment events, partnering with community organizations to create local enrollment coalitions, and generating media coverage to raise public awareness.

For example, Get Covered Illinois and the Illinois Department of Insurance partnered with the Illinois Department of Public Health to provide grants to community-based organizations that would educate and counsel communities through the enrollment process. In addition, given their experience working with vulnerable populations and rural communities, the department funded local health agencies to conduct enrollment activities, who are often the only service providers in remote areas.

A second successful initiative, developed by a local health department in Raleigh, North Carolina, involved sending letters highlighting open enrollment to self-pay patients who had received their services within the last two years. Through this effort, the health department connected with 15,000 individuals.

Public health collaboration with community health centers and state offices of rural health are other potential vehicles to assist in access to insurance coverage, as well as affordable, culturally- and linguistically-appropriate comprehensive services. These relationships are valuable in improving health literacy and individuals’ understanding of how to best choose and utilize health insurance plans.

Important Dates and Deadlines:

This year marks the fourth marketplace open enrollment period. The following dates and deadlines apply to the health insurance marketplace. Medicaid and the Children’s Health Insurance Plan have year-round enrollment.

  • Nov. 1, 2016: Open enrollment begins. Individuals and families may enroll, re-enroll, or change a 2017 Health Insurance Marketplace plan.
  • Dec. 15, 2016: Last day of the enrollment period.
  • Jan. 1, 2017: 2017 coverage begins for those who enrolled in a Health Insurance Marketplace plan between Nov. 1-Dec. 15.
  • Jan. 31, 2017: Last day to enroll in or change a 2017 plan. Beyond this date, enrollment and changes are only available for individuals and families who quality for a Special Enrollment Period or experience a qualifying life event.

Resources for State and Community Organizations

  • Affordable Care Act and Rural Health – The Health Resources and Services Administration Federal Office of Rural Health Policy holds office hours on alternating Wednesdays between 3-4 p.m. ET. These office hours function as a forum for rural health stakeholders to discuss best practices and innovative strategies to reach and enroll rural communities.
  • Community Catalyst published a toolkit for plans, provider groups, and communities to create meaningful consumer engagement.
  • From Coverage to Care is a roadmap developed by HHS that explains what health coverage is and how to access primary care and preventive services. It is available in eight languages.
  • What Worked and What’s Next? Strategies in Four States Leading ACA Enrollment Efforts – In this 2014 issue brief, the Kaiser Family Foundation outlines lessons learned regarding marketing and branding, outreach and enrollment initiatives, and consumer assistance.

First Steps for Individuals and Families:

  • The Centers for Medicare and Medicaid Services created a checklist detailing information and documents needed to apply for health insurance coverage.
  • Visit www.healthcare.gov to enroll in a health plan. This website offers portals for those applying for the first time, as well as those who are keeping or changing existing plans.
  • Individuals may also call 1-800-318-2596 or visit localhelp.healthcare.gov to find local community groups and navigators offering free enrollment assistance. 
Anna Bartels

Anna Bartels is an analyst for health systems transformation at ASTHO, where she supports the Integration Forum’s activities and projects related to payment and delivery reform.