Coverage Gains After the Affordable Care Act Among the Uninsured in Minnesota

Call, Kathleen Thiede; Lukanen, E O; Spencer, Donna; Alarcón, Giovann; Pintor, Jessie Kemmick; Simon, Alisha Baines; Gildemeister, Stefan

doi:10.2105/ajph.2015.302837

Cited by 7 publications

(23 citation statements)

References 8 publications

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“…To understand why eligible individuals remain uninsured, several studies have explored consumer experiences with the exchange Marketplaces and Medicaid expansion ( 16 , 23 , 24 , 26 , 29 , 30 , 40 , 41 , 74 , 89 ). Similar to the experiences in Massachusetts ( 20 , 66 ), common barriers to enrollment have included perceived cost of coverage ( 16 , 23 , 29 , 30 , 40 ), limited awareness about coverage expansions and eligibility ( 29 , 30 , 40 , 89 ), difficulty navigating the enrollment process ( 16 , 23 , 30 ), and language barriers ( 41 , 89 ); application assistance from navigators has helped to mitigate some of these barriers ( 89 ). Despite enrollment challenges, adults with new Marketplace or Medicaid coverage have reported high satisfaction with their insurance, doctors offered in network, ease of finding doctors, and affordability and access to care, comparable with reports from other insured adults ( 24 , 26 , 74 ).…”

Section: Aca Impacts On Coverage Of Low-income Populationsmentioning

confidence: 99%

The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations

Kominski

Nonzee

Sorensen

2017

Annu. Rev. Public Health

135

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The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law’s impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states. In addition, the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive. Although these early findings are generally consistent with past coverage expansions, continued monitoring of these domains is essential to understand the long-term impact of the law for underserved populations.

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Section: Aca Impacts On Coverage Of Low-income Populationsmentioning

confidence: 99%

The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations

Kominski

Nonzee

Sorensen

2017

Annu. Rev. Public Health

135

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“…Most of the studies identified [16][17][18][19][20][21][22] individual assistance as a key strategy used by healthcare providers and community-based organizations to help people enroll for health insurance. The terminology used to describe individual assistance varied.…”

Section: Individual Assistancementioning

confidence: 99%

“…Call et al [16] Minnesota (statewide) ▪ Organized outreach events in community centers, places of worship, townhalls. ▪ Collaborated with small business groups and healthcare providers.…”

Section: Community Outreachmentioning

confidence: 99%

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Health insurance enrollment strategies during the Affordable Care Act (ACA): a scoping review on what worked and for whom

Ercia

Lê

2021

Arch Public Health

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Background The Affordable Care Act (ACA) provided an opportunity for millions of people in the U.S. to get coverage from the publicly funded Medicaid program or private insurance from the newly established marketplace. However, enrolling millions of people for health insurance was an enormous task. The aim of this review was to examine the strategies used to enroll people for health insurance and their effectiveness after implementing the ACA’s coverage expansion. Methods The PRISMA Extension for Scoping Review (PRISMA-ScR) guided this review. Included studies were empirical studies that met the inclusion criteria and published between 2010 and 2020. Studies were searched mainly from two scholarly databases, CINAHL Plus and Medline (PubMed) using keyword searches. Hand searches from the references of selected journals were also performed. Content analysis was conducted by two authors in which codes were inductively developed to identify themes. Results There were 2213 potential studies identified from the search, but 10 met the inclusion criteria. The research design of the studies varied. Two studies were randomized trials, one quasi-experimental trial, three mixed-methods, two qualitative and two quantitative. All studies focused on strategies used to inform and help people enroll for either Medicaid or private insurance from the marketplace. This review identified three key strategies used to help enroll people for coverage: 1) individual assistance; 2) community outreach; and 3) health education and promotion (HE&P). Conclusion Community-based organizations were likely to use a combination of the three strategies simultaneously to reach uninsured individuals and directly help them enroll for health insurance. Other organizations that aimed to reach a wider segment of the population used single strategies, such as community outreach or HE&P.

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“…To augment the marketing efforts, the ACA required that every state Marketplace also establish a navigator program at the 2014 insurance expansion launch. Recent studies outside of Illinois have found that the strongest predictor of an uninsured individual completing the Marketplace application process was receiving help with enrollment from a navigator or application assister, and conclude that support for ongoing funding for this type of work will be important to maintain or increase the gains in insurance rates for those not insured or for those underinsured (Call et al, 2015;Sommers, Maylone, Nguyen, Blendon, & Epstein, 2015).…”

Section: Introductionmentioning

confidence: 99%

An Analysis of Community-Based Health Workforce Training Efficacy: Evidence From the Affordable Care Act Insurance Navigators in Illinois

Thornton

Leininger

Calhoun

2019

Pedagogy in Health Promotion

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Objectives. A community-based training with core competencies in health insurance, health care resources, and outreach for over 1,700 Affordable Care Act navigators in Illinois from 2013 to 2014 was designed, delivered, and evaluated by an academic–community partnership with expertise in health care, social services, health policy, and community outreach. Methods. Pre- and posttraining scores on a knowledge-based certification exam were linked to navigators’ baseline sociodemographic characteristic. Additionally, self-reported training evaluation and posttraining support were summarized from an online follow-up survey of the workforce. Results. Although the material was initially unfamiliar and the population heterogeneous, the training program brought all identified subgroups from a below passing mean score (71%) on the pretest up to above proficiency (80%) in a posttest assessment—suggesting a highly accessible training program across navigator sociodemographic groups. Navigators reported additional training on Medicaid and marketplace structure and eligibility to be very important. Conclusions. Supplementing or replacing diminishing federal funding for consumer outreach workforce training and support at the state or community level was found to be an important priority that can increase competencies in a diverse population. Findings also indicated that the inclusion of ongoing wrap-around resources remain in high demand among navigators in the complex, ever-changing health care landscape in the United States.

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Coverage Gains After the Affordable Care Act Among the Uninsured in Minnesota

Abstract: Targeting outreach, simplifying the enrollment process, focusing on affordability, and continuing funding for in-person assistance will be important in the future.

Cited by 7 publications

References 8 publications

The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations

The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations

Health insurance enrollment strategies during the Affordable Care Act (ACA): a scoping review on what worked and for whom

An Analysis of Community-Based Health Workforce Training Efficacy: Evidence From the Affordable Care Act Insurance Navigators in Illinois

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