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Contact: Ed Walz
Phone: (202) 657-0685

Report: ACA’s Next Phase Can Benefit from CHIP Outreach Lessons

A new brief released today by the bipartisan children’s advocacy organization First Focus identifies important lessons from Children’s Health Insurance Program (CHIP) outreach and enrollment efforts that can inform the next phases of Affordable Care Act (ACA) implementation. Outreach, Enrollment and Retention was authored for First Focus by Eugene Lewit, a Consulting Professor of Health Research and Policy at Stanford University. Lewit finds that successful state efforts to find, enroll in, and maintain coverage for hard-to-reach families can inform efforts to reach ACA-eligible individuals who remained uninsured. Although the initial open enrollment period for ACA Marketplace coverage has ended, enrollment for Medicaid and CHIP is open year round, and people who experience changes in certain life circumstances can continue to enroll in Marketplace coverage.

“From effective communications to cutting red tape, there’s a lot to learn from states’ successful CHIP implementation efforts. The time to start applying these lessons is now. Today, tomorrow, next week or next month, the CHIP and Medicaid enrollment window is always open,” said Bruce Lesley, president of First Focus.

The brief observes that several policies piloted during CHIP and children’s Medicaid implementation were incorporated into the ACA, including options to enroll online, by phone, or in-person, “no-wrong-door” auto-enrollment requirements, and assistance from trained navigators. But the analysis also points to other lessons learned through CHIP implementation that can improve enrollment now and during subsequent Marketplace open enrollment periods:

  • Employ communications designed for hard-to-reach communities, with culturally-relevant messages and trusted messengers;
  • Ensure that those covered during the initial open enrollment period have a positive experience, contributing to a positive word-of-mouth perception among eligible-but-uninsured communities;
  • Employ technology assertively and creatively, but avoid over-reliance on Web-based enrollment tools, which experience with CHIP suggests may be less useful for communities of color and other hard-to-reach populations; and
  • Assertively pursue opportunities to simplify re-enrollment processes, to maximize the likelihood that eligible individuals and families will retain coverage

The brief also notes that flexibility in enrollment opportunities and processes contributes to consistent coverage for children. To that end, CHIP and Medicaid do not have time-limited open enrollment windows.

These and other improvements have made CHIP extremely effective in covering uninsured children. Due in large part to CHIP and children’s Medicaid, the uninsured rate among children in America is at record lows, even in the wake of a recession that cost millions of families their employer-sponsored health insurance.

“CHIP works because federal and state policymakers were always looking for new opportunities to improve outreach, simplify enrollment, and keep kids covered. To keep that success story going, we’ve got to protect CHIP and apply CHIP’s lessons to implementation of the ACA,” said Lesley.