America Enroll America will help deliver on the promise of - - PowerPoint PPT Presentation

Connecting Millions of Americans with Health Coverage: Enrollment and Messaging Work

Martine Apodaca, Director, Public Education Campaign, Enroll America

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Maximize the number of uninsured Americans who enroll in health coverage made available by the Affordable Care Act

Enroll America will help deliver on the promise of affordable health care for millions of Americans

Enroll America will execute a national enrollment campaign using cutting-edge engagement strategies and will continue to build coalitions + share best practices

Our Mission

Health Coverage in 2014

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Medicaid Exchange (“Marketplace”) with Tax Credits Exchange or Private Plan

Income as a percent of the federal poverty level 133 400+

Coverage Options for Adults without Medicare

• r Employer-Based Coverage

An Opportunity for a Complete Continuum of Coverage

The Coverage Continuum in New York

Children Pregnant Women Parents Non-parent adults Exchange without tax credits Exchange with tax credits Medicaid expansion? Medicaid/CHIP 400% 300% 200% 100% Percentage of the federal poverty level

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The Enrollment Opportunity

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All States Expand Medicaid

41% 37% 9% 13% Eligible for Medicaid Expansion Eligible for Exchange with Subsidies Eligible for Exchange without Subsidies Not Eligible Due to Immigration Status

49 Million Total Nonelderly Uninsured

The Enrollment Opportunity in New York

Source: March 2011 and 2012 Current Population Survey 1,218,900 1,016,800 322,400 500 1,000 1,500 2,000 2,500 3,000 Non-elderly uninsured Thousands Likely exchange eligible, w/out financial help Likely exchange eligibile w/financial help Likely Medicaid- eligible

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Connect more than 2.5 million people to coverage

New York’s Uninsured: Demographic Profile

(Nonelderly Uninsured, Ages 0-64)

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54% 46%

Race/Ethnicity Percent of Uninsured Uninsured Rate White (non-Hispanic) 38% 11% Black (non-Hispanic) 18% 19% Hispanic 29% 23% Other 15% 21%

61%

Live in Families with at least One Full Time Worker

36% 11% 25% 14% 10%

Federal Poverty Level

Source: Kaiser Commission on Medicaid and the Uninsured, October 2012

The uninsured are a diverse group

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Age Gender Ethnicity Income (as % of Poverty Level

Male 55% Female 45% <138 51% 139-400 38% 19-25 17% <18 16% 26-34 21% 35-54 34% 55-64 12% 400+ 10% White 45% Latino 32% AfAm 15% Other 8%

Source: Kaiser Commission on Medicaid & The Uninsured, October 2012

Two thirds of the uninsured live in 13 states

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Uninsured by State

<230K 230K - 600K 600K - 1.1M 1.1M+

Number of Uninsured CA TX FL NY IL GA NC OH PA NJ MI AZ VA Rest of the U.S.

67% of uninsured live in 13 states

Source: Census Bureau, Current Population Survey, March 2011 and 2012

As a result, enrollment will be a challenge to overcome

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Enrollment in optional public benefit programs is well below 100% Limited public awareness of benefits

• f recent health reforms

Program % of Eligible Enrolled Adult Medicaid 62% Subsidized Medicare 33% Medicare Rx benefit

(low-income subsidy)

40% Unemployment benefits 72-83% Earned income tax credit 80-86% SNAP (food stamps) 54-71%

• f the uninsured don’t

know about the new health insurance exchanges

• f people who could

be eligible for the new Medicaid expansion don’t know about it

78% 83%

Lack of awareness provides opportunity for education with effective messaging

Source: Enroll America, November 2012 Source: ASPE, March 2012

Grounded in Research

Research and Branding We want to learn:

(1)The most effective messages to

reach different demographic and geographic groups?

(2)Who are the best messengers for

these communications?

(3)What are the best ways to

deliver these messages (e.g. television, radio, social media, etc.)?

Enrolling America in Health Coverage for 2014

Lake Research Partners GMMB November 5, 2012

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Collaborating with GMMB, Lake Research Partners conducted a national survey for Enroll America in September and October of 2012. The sample consisted of n=1,814 adults ages 18-64 with incomes at or below 400% of the Federal Poverty Level (FPL). The survey addressed the following topics:

• Who the healthcare “connector” is in households
• People’s experience searching for health insurance in the past
• Reactions to new health coverage options in 2014
• Testing key facts about coverage in 2014 and motivations to check out new options
• Reactions to the exchange portal
• Perceptions of affordability, including sample costs
• Testing ways to contextualize costs
• Kind of help they want when they enroll
• Best messengers and mediums for reaching audiences

First, some details about the research…

More details

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10 Focus Groups

• November 13-18 in Philadelphia, Columbus, San

Antonio, and Miami

• Groups include Latinos (English- and Spanish-

speaking), African Americans, young adults, parents (low and moderate income), childless adults (low and moderate income)

• Test branding and messages

Some Common Key Findings

• 1. Universal value of insurance
• 2. Cost and affordability are biggest barriers
• 3. Universal messages surrounding exchanges
• 4. Deep skepticism among consumers
• Previous bad experience
• Too good to be true
• 5. Insurance is confusing
• 6. Latinos vastly overrepresented among uninsured
• 7. Everyone wants help enrolling in coverage

For many, looking for health coverage is a negative experience.

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How they want to feel is confident, informed, secure, satisfied, and in control.

If you had to look for health insurance now, what feelings do you think you would have?

However, many have had negative experiences shopping for coverage in the past

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44% have shopped for health insurance outside their job and majority of these individuals have had one or more difficulties

17% 55% 66% 70% 77% "I was denied for a pre-existing condition" "Hard to know where to look to find a plan" "Hard to find a plan that covered care I need" "Hard to understand the fine print and… "Hard to find a plan I could afford"

Source: Enroll America, November 2012

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Initial reactions to new coverage options in 2014 are positive…

69% express interest in learning more about these options when they are

presented with basic information about the new coverage (12 % are neutral and 16% are not interested).

…but there is skepticism.

38% do not think they would find a plan they could afford. 33% do not think they would find a plan that covers all the care they need.

As you may know, in 2014 there will be new health insurance options for you if you need insurance. Most people now have health insurance through their jobs, and that will not change. But if you do not have insurance or if you lose insurance, you will be able to find a quality health insurance plan that fits your budget.

Sample premium amounts may not seem affordable…

After being presented with a sample premium amount for an individual or family

• f four at around 250% of the FPL, only 29% thought it was affordable (16%

neutral and 53% “not affordable”).

…but it seems more affordable when they consider yearly savings.

When they read “with this help [you/your family] would save [$xxxx] a year compared to what you would pay on your own right now,”

51% say it sounds affordable.

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Use Messages that Tap Into Security

In Broad Messaging, Introduce Options with Top Facts

In sum, here are our initial takeaways from the research so far…

• There will likely be a lot of initial interest in learning about coverage options

in 2014 but also a good deal of skepticism (will coverage really be affordable?).

• We need to acknowledge that looking for health coverage is a negative

experience for many. It will be key to present the exchanges as a different kind of experience.

• We need to lead by telling consumers what services are covered, that they

will not be turned down because of pre-existing conditions, and that they could get financial help.

• Our messages need to tap into the theme of financial security when trying to

drive consumers to exchanges – i.e., enrolling in coverage means not having to worry about big medical bills anymore; they will be able to find a plan that will fit their budget.

• Overcoming concerns about affordability will be a challenge. Always

contextualize the costs presented on exchanges – i.e., present yearly savings from the tax credits as a way to show the value of the coverage.

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5 Clusters of Targets

• 1. Uninsured, Unnecessary & Uninterested (11%)
• 2. Reluctant but Reachable (10%)
• 3. Desperate and Believing (8%)
• 4. Connected, Low-income Women (9%)
• 5. Insured but At-Risk (13%)

Demographic Profile 18 to 64 at or below 400% FPL

Uninsured, Unnecessary & Uninterested (11%) Skeptical, Young (Mostly) Men

Reluctant but Reachable (10%)Young, Diverse, Uninsured

Desperate & Believing (8%): Poorest, Sickest, Least Educated

Connected Low-Income Women (9%):The Medicaid/CHIP Connection

Insured but At-Risk (13%): Young, under 250% FPL

Fine Tuned Messages from the States

• The leading perceived benefit among

several populations in several states Peace of Mind

• A key message for women

Prevention

• Resonated most with men and young

adults in some states Protection from Financial Ruin or Injury

• Resonated with African Americans,

Latinos, and Medicaid eligible Access To Care

• Key message for low income, Medicaid

eligible Low cost or free health insurance coverage

• The biggest motivator in Massachusetts

Law and Associated Penalties

Building an Effective Campaign

Grassroots field efforts Creative use of social media National and local surrogates Education & engagement through partner entities with direct reach to target populations Earned media events and Activities in communities to magnify messaging Enrollment assistance by trusted community sources

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Paid advertising

• n TV, radio
• nline, and in

print media Paid advertising on TV, radio, online, and in print media Data, Analytics, Microtargeting Constituency engagement Strategic Partnerships

Campaign Soft Launch – Jan. 2013

Create ads, identify target placement – Jan - May 2013

Earned media events, community activities, paid media runs – Sept. 2013 – March 2014 Ramp down March 2014 – Aug. 2014 Ramp up Sept. 2014 –

• Dec. 7 2014

Timeline

Working Together

• Sharing research

& materials

• Coordinate

efforts with HHS & states Goals:

• Non-duplicative
• Value-added

Questions?

Martine Apodaca Director of Public Education Enroll America martinea@enrollamerica.org 202-737-6340