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Two Collaborations Drove Outreach and Enrollment in West Virginia

• The West Virginia Department of Health and Human Resources (DHHR) inROADS system permitted federally approved fast-track enrollment.
• DHHR market research showed that programs should frame outreach and enrollment in terms of increased coverage and access to care and that in-person assisters (IPAs) should not reference "Obamacare" or the Patient Protection and Affordable Care Act (ACA).
• West Virginians for Affordable Health Care and its Implementation Coalition and DHHR's Health Innovation Collaborative conducted outreach and enrollment activities.
• The Kanawha–Charleston Health Department educated stakeholders about ACA implementation and publicly encouraged Medicaid expansion.

Outreach and Enrollment Efforts Faced Challenges

• Describing the exchange to consumers was difficult.
• Staff spent most of their time at county DHHR offices, hospitals, or community health centers, so hard-to-reach populations were difficult to enroll.
• Only one qualified health care plan was offered through the exchange, and many consumers felt that it was not affordable.
• So-called "Obamacare" is unpopular in the state, which discouraged people from enrolling.

Some Factors Helped Local Health Departments' Efforts

• The dire health conditions in West Virginia motivated people from different sectors to work together to support outreach and enrollment.
• Most people in West Virginia have known each other for years and in diverse settings, thus forging strong bonds of trust.
• Local health officials are seen as well-informed, credible, and trusted sources of information.