Eva Bermudez was one of nearly 300 people tasked with helping the uninsured get covered as Obamacare rolled out last fall.
Her job might have seemed easy compared to those of her counterparts. An organizer with the union CSEA SEIU Local 2001, Bermudez focused her efforts on union members, many of whom had technological experience, Internet access and the ability to sign up for coverage online or by telephone.
Even so, they came to her for help.
"They wanted that hand-to-hand contact," said Bermudez, who helped close to 1,000 people sign up for private insurance or Medicaid through the state's health insurance exchange, Access Health CT.
She described her experiences to the exchange's board Thursday, imploring state officials to make the same type of in-person assistance available this fall, when the next round of open enrollment for health care coverage under Obamacare begins.
The federal funding for the assistance program ran out earlier this year, and there's no publicly available plan for what will happen during the next enrollment period, which begins Nov. 15.
Others who helped people sign up for coverage last fall and winter made similar appeals. They spoke of helping people who didn't initially understand the application questions or who had questions about what insurance was. Some said people have returned with questions about how to use their coverage or get care, even though the assistance program is now over.
"Every state is struggling to figure out how to keep it going," Access Health CEO Kevin Counihan said.
Connecticut will have an in-person assistance program in the fall, Counihan said. But he said it might differ from the previous version. And how it will be funded remains unclear.
During the previous open enrollment period, the program ran on close to $2.6 million in federal funds, with additional grants from foundations.
This year, Access Health plans to contribute about $456,000 in funds and supplies, and the state Department of Social Services might come up with some money, too, Counihan said. The exchange is also applying for federal money for the program.
And Counihan said the program could be more targeted. Two-thirds of those who remain uninsured are concentrated in 10 cities. Most are eligible for Medicaid. And there's data on which assisters were the most effective at helping people sign up.
"Now we can be a lot more focused," Counihan said.
Fewer Uninsured, But Harder To Reach
Recent research done on behalf of the exchange indicated that more than half of those who signed up for coverage were previously uninsured.
"We have fewer people to go after in terms of the uninsured population," Jason Madrak, Access Health's chief marketing officer, told board members Thursday. "But finding those people can be quite difficult."
Even though research suggests that most of the uninsured are concentrated geographically, Madrak noted that people who haven't signed up for coverage are those who didn't respond to a major marketing and outreach effort last year, suggesting the need to refine messaging and enrollment assistance.
Benjamin Barnes, the state budget director and an exchange board member, said it would make sense to put more emphasis on "trust-based channels" like in-person assisters to reach people who haven't responded to mass marketing, who might have other challenges.
"As we shrink down, we're probably going to need to have more high-touch, high-trust interactions with our customers," he said.
But the next open enrollment period won't just be about finding the uninsured; it will also require keeping people covered. Customers who signed up for private insurance last year will have to re-enroll, and there will be many new plan options to choose from.