By Laura Tobler

A final push to enroll people into health insurance is on in states and communities across the nation.

The initial open enrollment period ends March 31, meaning most people who have not signed up may have to pay a fine and wait until the next open enrollment period opens in November. People who are eligible to enroll in Medicaid and the Children’s Health Insurance Program (CHIP) are not subject to the March deadline and can enroll anytime.

As the insurance deadline nears, recent numbers show a significant uptick in enrollment. As of Feb. 25, the U.S. Department of Health and Human Services reported that 4 million Americans had signed up for private health insurance coverage through federal or state health insurance exchanges, with large jumps among key groups, including young adults and Latinos. Millions more have enrolled or were determined eligible to enroll in Medicaid. 

According to CMS data, from Oct. 1 to Dec. 31, 2013, more than 6.3 million total new eligibility determinations were made for Medicaid and CHIP. Keep in mind, however, that this is a total number that reflects determinations for all Medicaid eligibility groups, not just adults made newly eligible for Medicaid by the expansion.

Many states have played a key role in getting the word out and helping people enroll in Medicaid, CHIP or private insurance. Colorado—one of 17 states and the District of Columbia that runs a state-based marketplace—illustrates some of the many forms that outreach can take. 

From February through March, Connect for Health Colorado sponsors events that provide free tax help and health insurance enrollment assistance from trained health coverage guides. Other strategies included a statewide RV tour in December, expanded Sunday phone support, advertisements at professional sports venues, and “Health Coverage Sunday” events at churches. Between October and March 1, 220,000 Coloradans had signed up or been approved for coverage—135,460 enrolled in Medicaid and 84,540 enrolled in a private plan through the state’s exchange.

In Connecticut, consumers can shop for insurance in bricks-and-mortar stores, through a website, or through a phone center staffed by navigators who speak different languages. The state’s exchange also conducts enrollment fairs in different cities and towns at least four times a week.

Despite enrollment increases leading up to the March deadline, states are sure to experience ongoing challenges after the initial enrollment period ends. Consider this: In a February poll, just one-quarter of uninsured people said that they knew about the upcoming deadline to enroll and avoid paying a penalty. States will continue to be involved with helping people understand their options and the law’s expectations will be ongoing and perhaps even more challenging once “low-hanging fruit,” or the first wave of enrollees, have signed up for coverage.

Laura Tobler is a program director with NCSL's Health Program.

Posted in: Public Policy
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This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.


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