Health Equity in Focus: Taking a Closer Look—Successful enrollment strategies in New Jersey
In New Jersey, the final enrollment numbers attest to the coordinated efforts enrollment specialists and consumer health advocates activated across the Garden State. With more than 162,000 New Jerseyans enrolled in the Marketplace in this first open enrollment period, and an additional 98,000 enrolled in New Jersey Family Care (the state’s Medicaid and CHIP program), much of the success is due to a final push of community events that helped increase the enrollment numbers.
I caught up with Aida Rivera, Health Care Organizer at New Jersey Citizen Action (NJCA), to find out a bit more about the advocacy community’s efforts across the state, and to learn about one program in particular: the Latino Outreach and Enrollment Project.
While we don’t yet know demographic breakdowns regarding enrollment from this first open enrollment period, Latinos face the highest uninsured rate in the nation—in New Jersey 29 percent of Latinos did not have health insurance in 2012. NJCA’s project aimed to address this disparity by working with nine community-based organizations on the ground in targeted areas, focusing on the need for cultural competency, trusted messengers, and ample opportunities to move past the numerous stigmas that many Latino and immigrant families previously faced in trying to access health insurance coverage.
NJCA selected the organizations based on the existing work being done in their communities, and the number of uninsured Latinos in those areas. In total, the project’s organizations serve nine different counties in north, central and south New Jersey, and include community health clinics as well as community centers where residents can tap into social and community services.
As part of the project, organizations’ staff are trained as certified application counselors (CAC), allowing staff and volunteers the opportunity to help enroll community members into the Marketplace. While the first open enrollment period has ended, many of the individuals and families impacted by this program are eligible for New Jersey Family Care and are eligible to enroll year round, thus ongoing support from CACs in targeted communities is vital. NJCA also provides technical assistance to help prepare the organizations with up-to-date information so they can educate their communities.
On the national level, outreach to the Latino community did not go as smoothly as expected. Delays in the unveiling of CuidadoDeSalud.gov, the Spanish language version of HealthCare.gov, and limited access to linguistically appropriate materials made the process more difficult. However, New Jersey managed to surprise the country when they doubled their enrollment numbers after March 1. Aida mentioned that engagement within the Latino community was a critical component of this surge in enrollment numbers. Because all of the project’s organizations have gained the trust of those they serve, enrollment proved to be more successful.
Additionally, the organizations have collected a number of best practices that work well within their targeted communities. For example:
- Advocates purchased ‘Leap Frog’ reading pens, which read the words of a document out loud to the user. Given that literacy may be an issue for many consumers, not to mention health literacy, advocates found that by pairing consumers with this tool, they were more likely to return to complete their application as they felt greater control over the process and empowered to enroll themselves.
- A Volunteer Income Tax Assistance (VITA) program partnership was developed to catch consumers that still needed to enroll in the Marketplace. With numerous VITA sites across New Jersey, this was the perfect solution to increasing enrollment numbers. Consumers that used the free tax assistance already had the needed documents to complete a Marketplace application.
During the open enrollment period, health literacy was by far one of the most difficult hurdles to overcome. Advocates found that many of the project’s targeted communities knew very little about the Affordable Care Act, New Jersey Family Care, or health insurance at-large. Add to this the misinformation, and uncertainty facing families of mixed immigration status, these organizations continue to have their hands full supporting outreach, education, and enrollment efforts.
Now that enrollment is over, it is important to continue educating the community. Reminding the community that enrollment for New Jersey Family Care is open year round is at the top of the list, as is encouraging families that regardless of mixed immigration status, undocumented family members will not be jeopardized. Additionally, it is critical to educate the community about the available tax credits in preparation for the upcoming open enrollment cycle.
Whether you are just starting out, or you have been actively engaging diverse coalitions, we encourage you to continue this important work. For more information and resources on health equity, visit our Health Equity issue page.