Brokers Play Key Role In ACA, Medicaid Enrollments

By Cyril Tuohy InsuranceNewsNet

By Cyril Tuohy

A new report by the Kaiser Family Foundation has found that health insurance brokers played a key role in helping enroll Medicaid recipients and uninsured residents in four states under the Affordable Care Act (ACA).

In some cases, brokers worked the front lines at sign-up centers. In other cases, brokers worked behind the scenes in coordinating enrollments with marketplace “assisters” to help people choose plans best suited to their needs.

The four states studied by the Kaiser Commission on Medicaid and the Uninsured were Connecticut, Colorado, Kentucky and Washington.

Despite early fears, “a large number of brokers in the four study states were certified and often worked collaboratively with assisters to enroll uninsured people,” the Kaiser report said.

Taylor Roddy, marketing and communications manager at Connect for Health Colorado, the state’s health insurance marketplace, said brokers and assisters at walk-in sites served as powerful draws to help customers get enrolled in plans. In 2011-2012, 17 percent of the state's nonelderly population was uninsured.

More than 141,000 Colorado residents were enrolled through their state’s Connect for Health Colorado plan, which trained more than 1,500 brokers and agents, the Kaiser report found. Those brokers played a critical role in helping enrollees with specific health needs such as HIV and diabetes, and with helping to inform consumers about which drug formularies and services were covered in each plan.

In Washington state, brokers enrolled more than 100,000 people during open enrollment, including one in 10 new Medicaid enrollments, the report found. As many as 163,207 individuals selected a health plan through Washington’s Health Plan Finder program, the report said.

In Kentucky, about 40 percent of qualified health plan enrollments were facilitated by insurance brokers through the state’s Kynect program, the report found. With 24 percent of its nonelderly population uninsured in 2011-2012, and with more than 1.1 million individuals out of a population of 4 million enrolled in Medicaid, the Bluegrass State saw 82,747 individuals choose a plan through Kynect.

“Kentucky did have a very successful outreach campaign,” Lisa Lee, deputy commissioner with the Kentucky Department of Medicaid Services, said in a briefing on the enrollment initiatives.

In Connecticut, 15 percent of nonelderly persons were uninsured in 2011-2012, and the state is home to a large Portuguese-speaking immigrant population. As many as 79,192 individuals selected a plan through the state’s Access Health program, Kaiser researchers found. Brokers there created fact sheets in Portuguese.

In one Connecticut hospital, brokers worked in tandem with assisters to clarify Medicaid questions and to explain plan details and private coverage options, according to the report.

Kevin Counihan, chief executive officer of Access Health, said the marketing channel with the most influence on enrollees was word-of-mouth references and recommendations by friends and colleagues. Access Health uses as many as eight marketing channels to reach out to consumers.

Kaiser published its findings in an issue brief titled “What Worked and What’s Next? Strategies in Four States Leading ACA Enrollment Efforts.”

The four states, which decided to set up their own exchanges, didn’t rely on the federal government’s exchange, which was the default option for states that didn’t provide their own marketplaces.

State-run marketplaces exist in Washington, Idaho, California, Colorado, Minnesota, Kentucky, Hawaii, Maryland, New York, Vermont, Massachusetts, Connecticut and Rhode Island. Oregon, Nevada and New Mexico have state-run marketplaces using the federal government’s website.

ACA requires that most people be insured.

Millions of Americans are covered through employer-sponsored plans, and people not covered through employers are covered through plans bought in the individual market. But until this year, millions more were uninsured, either because they didn’t have a job or because they couldn’t afford coverage in the individual market.

Despite early glitches with state and federal Web-based enrollment programs, health officials have called the enrollment process a success. As of April, 8 million more people were insured than in the fall of 2013, when enrollment began.

Of that 8 million, about 6 million individuals found coverage through the expansion of Medicaid; others found coverage through their employers; and the rest bought coverage through the state and federal health exchanges, the Kaiser report found.

Another study by the Rand Corp. estimates that the share of the U.S. population that is uninsured has dropped from 20.5 percent to 15.8 percent under the ACA.

The next open enrollment period for insurance marketplaces begins Nov. 15.

Cyril Tuohy is a writer based in Pennsylvania. He has covered the financial services industry for more than 15 years. Cyril may be reached at [email protected].