The dramatic downsizing of Enroll America, the not-for-profit group tasked by the White House to educate Americans about the Affordable Care Act, could depress enrollment in states where local lawmakers oppose the law.
Facing dwindling financial support, the group is slashing 100 jobs and shifting its focus to training existing community groups and health providers to publicize the law, according to published reports. Over the past two years, the group has focused most of it outreach work in conservative-led states where without its help few residents would have gotten information about signing up for coverage. These states include Florida, Georgia, North Carolina and Texas, four of the five leading states in terms of sign-ups, according to HHS.
Enroll America says its staff and volunteers were able to directly contact nearly 874,000 consumers either in person or via phone around the country during the second open enrollment, a 37% increase over the previous enrollment cycle.
“The next phase of our organization is about making our success permanent by embedding the enrollment tactics we've learned into local organizations that are beyond the reach of the political back and forth in Washington,” Enroll America President Anne Filipic was quoted as saying in an under-the-radar piece published last month by Morning Consult.
“In the coming years, as health coverage enrollment becomes a way of life and the number of uninsured continues to decrease, we'll begin passing the baton on to local organizations and leaders who will continue to do this work for years and decades to come,” she said.
Without Enroll America's outreach muscle, the Obama administration could struggle during the third open-enrollment period, which kicks off Nov. 1. With 11.4 million sign-ups across state and federal exchanges, it's possible that there is no more so-called low-hanging fruit—people who badly needed insurance and would be easily swayed by the first round of advertising and outreach.
The remaining people who are eligible for coverage but have yet to enroll are likely to be much harder to reach and require more, not less, manpower.
HHS struggled to make any meaningful progress in getting minorities to sign up during the second open enrollment, despite repeatedly releasing data that these individuals would benefit most from the coverage options under the health reform law.
In fact, the agency appeared to lose ground in attracting minorities to the federal exchange. The percentage of Latino and Asian enrollees on federally operated exchanges remained flat compared with last year at 11% and 8%, respectively. The percentage of African-American enrollees dropped to 14% from 17%.
According to a recent analysis by the consulting firm Avalere Health, insurance exchanges relying on HealthCare.gov for enrollment had signed up 76% of eligible consumers making between 100% and 150% of the federal poverty level. The percentage declined precipitously for higher-income consumers—the exchanges enrolled just 16% of those earning between 300% and 400% of the poverty level.
It's still unclear if HHS has reached its goal of 9.1 million "effectuated" sign-ups—meaning people who signed up and paid for at least one month of coverage. HHS has said it likely won't have that information until the fall. It has also not yet announced its enrollment goals for the next open-enrollment period.