Welcome to Health Reform Watch, Sarah Kliff’s regular look at how the Affordable Care Act is changing the American health-care system — and being changed by it. Check back every Monday, Wednesday and Friday afternoon for the latest edition, or sign up here to receive it straight from your inbox. Read previous columns here.
Programming Note! Health Reform Watch will continue stronger than ever under new leadership -- stay tuned for an announcement very soon on this front. But today is Sarah's last day at The Washington Post. She writes: "It has been such an incredible experience working here for the past three years and being part of both Wonkblog, and the Washington Post's health reporting team. Thank you to everyone who has sent in tips, ideas and animal videos too — you all have contributed immensely to my reporting, and helped me stay sane on a pretty crazy beat!"
You'll be seeing some new faces here soon who are going to keep delivering the great journalism that has made Wonkblog such a fun place to work. And now to your regularly scheduled health policy news.
Enroll America is gearing up for its own version of March Madness — one that has nothing to do with basketball.
The pro-health law group has spent months now honing its outreach techniques and developing data-intensive maps meant to help their 18,000 volunteers and 2,000 partner organizations reach as many uninsured people before open enrollment on the exchanges ends March 31.
The end of open enrollment has arguably taken on additional significance after the botched roll-out of HealthCare.gov, which made it difficult for shoppers to sign up in October and November. The Obama administration is about 1 million people short of where it had projected it would be on enrollment at the end of January.
"We're at this moment now, six weeks out from the end of open enrollment, and we're looking at every tool that we have at our disposal about how we should be focusing our efforts," Enroll America president Anne Filipic says.
One new tool that the group has begun rolling out to partner organizations are a set of maps that show where, down to the census tract, uninsured Americans live — and how well that does, or doesn't, line up with where people meant to help them enroll in Obamacare are based. In Enroll America's eyes, this is what Tampa looks like:
And here's Phoenix:
"It's a bit of a Herculean effort," says Matt Saniie, Enroll America's national data director. "If we tried to just do this from D.C. we would get nowhere, but luckily we're blessed to to work with our folks on the ground. We've been collecting this information since before open enrollment started."
Enroll America has begun distributing this data to its partner organizations, who are using it to organize their outreach efforts for the next six weeks. That includes Philip Bergquist, direct of health center operations at the Michigan Primary Care Association. If you think of Michigan as a mitten, his group noticed a lack of outreach assisters in the thumb (more formally, this is the central east part of the state).
"In the thumb, its a more rural area and there are very few permanent assisters there," said Bergquist, whose group has an Enroll America grant. "A group of organizations based out of Flint are now taking turns doing events out in that area, whether its something like going to a partnership with a local business. The group is essentially developing and sharing a schedule."
Back in Washington, Enroll America is honing its own outreach techniques. Filipic says that while they still do door-to-door canvassing, the group has moved to focus more on bigger events where they can reach more people at once.
"When we started last summer, that was a large part of where we were focusing our efforts," Filipic says. "We've found, though, that sometimes you're able to reach more people in a short period of time if we go to events where people are already gathered."
These aren't necessarily health-centric events: Out in Michigan, Bergquist said they've tried especially to turn up at events where people might not be thinking about health insurance — but where they can get the conversation started.
"We're focusing on events that don't typically have a health focus," he says. "For example, last weekend we went to a big outdoor fishing tournament. We can hang out in the warming tents and it gives us an opportunity to mobilize via word of mouth."
Enroll America has tweaked its message, too, to focus more heavily on the availability of financial help to purchase insurance coverage. Their research has shown this tends to be the area where the uninsured have the lowest awareness of the health-care law — but tends to motivate people the most. E-mails that Enroll America sends out, for example, tend to get opened more when there's something in the subject line about financial assistance — and less when it's a personal story of somebody else who gained coverage.
"It is the number one thing that really demonstrates to consumers that something is different about the insurance market and it's worth checking out," Filipic says. "It needs to be the lead point, instead of one of four or five points. We've made it our top messaging point. In our field scripts, it was something we were talking about, but it often wasn't the first thing, so we changed that."
KLIFF NOTES: Top health policy reads from around the Web.
One-fifth of Obamacare enrollees haven't paid their first month's premium. " One in five people who signed up for health insurance under the new health-care law failed to pay their premiums on time and therefore did not receive coverage in January, insurance companies and industry experts say. Lindy Wagner, a spokeswoman for Blue Shield of California, said that 80 percent of those who signed up for its plans had paid by the due date, Jan. 15. Blue Shield has about 30 percent of the exchange market in the state." Robert Pear in the New York Times.
HealthCare.gov will be down for National Youth Enrollment Day this weekend. "Saturday is National Youth Enrollment Day for Obamacare, a day designed to help make up for youth recruitment time lost while HealthCare.gov was down last year. It will be marked by a broad array of events, from Head Start information sessions to pub crawls. The day will also feature a HealthCare.gov outage that came as a surprise to the White House allies who have been planning Feb. 15 enrollment activities for weeks. 'We just found that out,' said Aaron Smith, co-founder of the recruitment group Young Invincibles. 'Obviously it’s unfortunate.' " Evan McMorris-Santoros in Buzzfeed.