Families USA produced the Public Policy Toolkit for Enrollment Assisters to give assisters and others the knowledge and tactics they need to be effective advocates.
As an enrollment assister, there are numerous state and federal policy areas that affect your work. Families USA has expertise in the issues listed below, and our experts are happy to help you learn more. Of course, these are not the only health policy areas that touch your work, but they are a great place to start.
Enrollment in Health Insurance
The Affordable Care Act (ACA) has expanded health insurance to millions of Americans who were previously unable to get coverage. Enrollment assisters know first-hand the impact that getting coverage for the first time can have on consumers. Assisters are also uniquely able to highlight the effects insurance has on consumers’ lives, and to work with officials to further improve access and quality.
In terms of enrolling individuals and families in health coverage, there is still a substantial amount of work left to do, including:
- enrolling hard-to-reach populations
- keeping people enrolled and helping with post-enrollment issues
- making sure the enrollment process is simple and easy to navigate
- ensuring that consumers are equipped with the tools they need to use their coverage wisely
Enrollment assisters are experts in these areas and are the ideal messengers to raise these issues with public officials. Use any of the examples of how to reach out to officials listed in “Reaching Out to Public Officials” to begin a conversation on this issue.
Visit our Enrollment page for more information on this policy area.
Private Market Health Insurance
Many people have gained coverage by enrolling in private insurance plans through the marketplaces established by the ACA. But that’s not the end of the story—advocates and others continue to work to make sure that all private insurance plans provide access to care that is comprehensive and affordable.
Federal and state legislators, insurance regulators, and marketplace officials can help improve private insurance plans by:
- implementing policies to address the affordability of premiums
- ensuring that these plans make health care affordable for consumers, including setting reasonable deductibles, exempting services from deductibles, and addressing high cost-sharing for prescription drugs
- ensuring that plans have adequate provider networks
- enacting and enforcing other consumer protections
You can help educate officials about these issues. And by telling officials about the obstacles that consumers still face and about the changes that would make marketplace plans more accessible and affordable, you can help solve these problems.
Visit our Affordable Care Act page for more information on private market insurance.
Medicaid and the Children’s Health Insurance Program
Medicaid has been a health care safety net program for low-income families, children, and seniors for more than 50 years. One of the most important provisions of the ACA is the expansion of health coverage to low-income people through Medicaid. However, some legislators may be unfamiliar with how the Medicaid program works and who it helps. Or they may oppose expansion or believe that the program should be restructured or cut.
The Children’s Health Insurance Program (CHIP) is another important safety net program, providing millions of children with a healthy start in life. CHIP is a lifeline for parents who may not qualify for Medicaid but who cannot afford private insurance for their children. Thanks to CHIP, kids who might not otherwise have health coverage have been able to receive preventive care; medication; and vision, dental, and hearing screenings.
Help educate your public officials about how Medicaid and CHIP have helped your community. Depending on your state’s expansion status, you can also educate your officials about the benefits of Medicaid expansion for your state and about the “coverage gap” (which affects individuals and families who are too poor to pay for private insurance but who do not qualify for their state’s current Medicaid program).
Visit our Medicaid page for more information on this policy area.
Improving the Health Care System (Health System Transformation)
Many states are working to change the way that health care is delivered and paid for in order to improve the quality of care, reduce the cost of care, and improve the overall health of the population. That is what “health system transformation” means. It is essential that consumers—and those who work with them--have a voice in this changing health care landscape.
Advocacy activities will vary from state to state, but there are ample opportunities for individuals who work directly with consumers to share their feedback on how well the health care system works for consumers and to weigh in on efforts to improve the system.
Visit our Health System Transformation page for more information on this issue area.