(Story updated with detail and comment at 7 p.m. Central time.)
Hospitals and health insurers that will benefit from the new paying customers generated by next year's expansion of insurance coverage under the health reform law have moved quietly on their own to promote consumers' new options.
The moves come after HHS Secretary Kathleen Sebelius
came under fire from Republicans in Congress, who have questioned whether she solicited firms and institutions regulated by her department to contribute money to Enroll America, the privately organized not-for-profit that is working to build public awareness about the new law. Congress has not appropriated funds to educate the uninsured about their coverage options under the new law, which will be offered to the public starting Oct. 1 when open enrollment begins for the insurance exchanges
The high-profile criticism—Sen. Lamar Alexander (R-Tenn.) likened the administration's efforts to sidestep the funding ban to the Iran-Contra scandal—may be having a chilling effect on some healthcare providers' willingness to contribute to Enroll America's campaign. At a media briefing Tuesday, officials from the new group refused to divulge how far along it was in achieving its $100 million fundraising goal.
“We feel really good about where we're headed here,” said Anne Filipic, the former Obama administration official who now serves as president of Enroll America. When asked directly about budget figures, she said, “We continue to see enthusiasm out there. We are confident that we'll have the resources we need to do the job.”
Some provider and insurance groups are beginning to pledge support for the campaign. Catholic Health Initiatives, a member of the Catholic Health Association, expects to make a donation in the near future, said Colleen Scanlon, senior vice president of advocacy for CHI.
“We haven't officially contributed yet,” Scanlon said, adding that the health system has had conversations with representatives from Enroll America. “They've done a few education sessions and outreach efforts with us to begin our own learning of opportunities in Enroll America,” she added. “We see them as a positive partner as we move forward to enroll people across the country.”
Enroll America has launched an enrollment campaign across 18 states that officials say will target many who are unaware of potential coverage. The organization will host more than 50 events this week to kick off Get Covered America, a campaign focused on targeting individuals who are unaware of the health insurance benefits available to them in the Patient Protection and Affordable Care Act.
Filipic, no stranger to large-scale campaigns after working on President Barack Obama
's 2008 presidential bid, said Enroll America's research shows that 78% of people are unaware of the options they have, and that they prefer to learn about those options in what she called a “just-the-facts sort of way.”
Enroll America is expanding its current staff of about 50 to about “200 or so” in the months ahead, Filipic said. The group will also rely on help from thousands of volunteers across the country.
The push joins efforts underway by the nation's Catholic healthcare trade group and insurers that rely on websites and community groups to promote the 2010 health reform law coverage options.
“I know Enroll America continues to try to do their fundraising, and I think like any campaign they have enough money to establish field offices,” Michael Rodgers, senior vice president for advocacy and public policy for the Catholic Health Association, told Modern Healthcare. “And I think they are likely to enhance that, depending on what they will be able to garner.” Sister Carol Keehan, president and CEO of the CHA, is a member of Enroll America's board of directors
According to Rodgers, CHA has contributed a total of $100,000 to Enroll America, which it donated before this year. Neither Sebelius nor anyone else from her department contacted CHA to solicit funds for Enroll America, Rodgers said.
“I can't say definitely, but my feeling is that our contributions will continue,” Rodgers said, adding that the CHA will continue to work with its member hospitals and ministry partners to help make people aware of their coverage options. And the organization produced a video—“Ready, Set, Enroll”
—that Rodgers said it is urging CHA's members to post on their websites.
Representing the nation's safety-net providers, the National Association of Public Hospitals and Health Systems serves as a member of Enroll America's Advisory Council
Although NAPH supports Enroll America's purpose, it has not donated money to the group and it doesn't seem likely to in the future, said Beth Feldpush, senior vice president for advocacy and policy at NAPH. And Congress' heightened interest in HHS' fundraising efforts for Enroll America is not the reason why.
“We're a pretty small organization so it's pretty challenging to make donations. We're very supportive of enrollment efforts,” Feldpush said, adding that she's concerned that the appropriate work is done to help patients at NAPH member hospitals overcome barriers to enrollment. For instance, Feldpush explained, more than 100 languages are represented within this patient population, whose members often face problems related to transportation and health literacy.
Meanwhile, some of the nation's large insurers are also getting involved in promoting the forthcoming health insurance exchanges, launching their own education and outreach initiatives. Be Covered is one such campaign, run by Health Care Service Corp., which operates Blues plans in Texas, Illinois, New Mexico and Oklahoma.
“We started to conduct research late last year in all of our states and found that the vast majority of uninsured
people were confused about the new healthcare law and had little experience with the industry,” David Sandor, HCSC vice president of public affairs and corporate communications, told Modern Healthcare. Be Covered “is a grassroots campaign that introduces the uninsured to new health insurance options under the ACA.”
Through Be Covered, HCSC is currently partnering with more than 120 groups across the four states, including civic organizations, schools, religious institutions and physician practices, in order to provide information to uninsured people through events, print and digital content, texting and e-mail campaigns, and Spanish language newspaper inserts.
“We call this social marketing,” Sandor said. “We're trying to achieve a social good instead of sell a product or a service. We want to get people enrolled and engaged.”
Cigna Corp. is following a similar model in five states. The Bloomfield, Conn.-based insurer has chosen Arizona, Colorado, Florida, Tennessee and Texas as the states in which it will initially participate in the public health insurance exchange marketplace. And in those locations, the insurer is working to promote and explain the exchanges to both its current and future customers.
“It's a very complex dynamic,” Joe Mondy, company spokesman, said. “These exchanges really open up access to health plans for a lot of people who may have never had a health plan and may have never had a family doctor.”
According to Mondy, Cigna surveyed some 7,000 people to understand their concerns regarding the exchanges. What they found was that they needed help making informed choices about their plans and even assistance in selecting a family physician. Cigna plans to offer a year-round phone line for customers as they sign up for products, as well as continue to answer their questions once they have registered.
“It doesn't end when they enroll on Oct. 1,” Mondy said.
During the call with reporters on Tuesday, Filipic did not offer a projection of how many uninsured individuals her group hopes to enroll in the first year, and added that while the group is aggressively launching this campaign, success will be measured over the long term.
Meanwhile, the group is using data analytics to find the uninsured and will use social-networking tools, phone calls, mailed items and door-to-door visits to reach them. And it will host strategy sessions to educate volunteers about what they need to know about the campaign before they educate members of the public. In addition to working with partners across the country—including hospitals, insurers, drug companies, businesses, retailers and labor groups—Enroll America's events this week will involve having a presence in communities, including a table at a farmer's market in Austin, Texas, and visiting churches on Sunday.
“We're looking at partnerships with sports leagues and celebrities,” Filipic said. “What are some of the innovative strategies that allow us to have a more individualized campaign?” she added. “We know this is a personal issue for folks. We need to think about what will make this easy for consumers.”Follow Jessica Zigmond on Twitter: @MHjzigmondFollow Rachel Landen on Twitter: @MHrlanden