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Challenges to outreach and enrollment

Challenges to outreach and enrollment include inconsistencies between national and state enrollment processes, lack of access to major grant funding, underestimations of the time required to complete enrollments, and high insurance costs.

Partnerships

LHDs can be creative with limited resources and serve as an important liaison between state agencies and community organizations or residents.

Some factors — such as a long history of partnership and strong communication; complementary, not competing, interests; strong community presence; the ability to influence policy; and shared decisionmaking across alliances — help LHDs' efforts.

Trust

Trust established between LHDs and residents facilitated LHD communication to harder-to-reach residents facing barriers to enrolling in health insurance and the public about the availability of health services.

LHDs are skilled at contracting with local community-based organizations that have reach into specific communities for outreach and enrollment.

Policy and Practice

The diverse perspective of LHDs is critical to understanding the ACA, for successful outreach and enrollment efforts, and helping to shape the dialogue around health insurance within the community.

LHDs found creative ways to apply the practice of public health to outreach and enrollment.

Case study discussants identified different ways that national and federal agencies can support LHDs and their partners including:

• Deploying national messaging to illustrate the importance of insurance.
• Funding and education to support LHD participation in outreach and enrollment, especially in nonexpansion states.
• Real-time enrollment information.
• New staffing models to help LHDs link consumers to care after enrollment.