Connecticut is attempting a novel strategy to address health disparities among racial and ethnic minority populations: Teaching people from those communities to become health insurance agents and brokers.
The Constitution State's health insurance exchange, Access Health CT, last year launched its Broker Academy, a free training program for those living in underserved areas to become licensed health and life insurance brokers. The exchange reckons these newly minted salespeople will return to their communities and sell insurance policies to their neighbors, boosting insurance coverage and health literacy.
While Connecticut’s 5.6% uninsured rate is lower than the national average, Hispanic people are four times more likely and Black people three times more likely to be uninsured compared to white people, according to state data.
“We’re training those students who knew very little about health insurance, and then those students are talking and educating their families and friends and community members that are hard to reach, that are really nonresponsive to a lot of efforts from most agencies,” said Tammy Hendricks, head of health equity and outreach at Access Health CT.
Connecticut's model may catch on in other states that operate health insurance exchanges. Washington state created an advisory committee in August to develop a broker academy through its Washington Healthplanfinder. Health insurance exchanges in California, Colorado and Rhode Island also have expressed interest, said Jalisa Clark, a research fellow at the Georgetown University Center on Health Insurance Reforms.
Tackling health disparities through the insurance system aims to address a legacy of racism in the insurance and financial services sectors. This is especially resonant in Connecticut, where the capital city of Hartford is known as the "Insurance Capital of the World."
Until President Franklin Roosevelt signed the McCarran-Ferguson Act in 1945, fraternal benefit societies—a type of insurance carrier—targeted Black people with high-premium, low-value life insurance policies. Homeowners insurance agents often refused to sell to people of color until President Lyndon Johnson enacted the Fair Housing Act in 1968.
“There's just an undeniable history of racism and discrimination in the insurance industry in general, going back literally hundreds of years since slavery in the United States,” Clark said. “That aspect of discrimination in the insurance industry impacts people trusting insurance and insurance brokers today.”
The National Association of Insurance Commissioners established a special committee to address racial issues within the industry in 2020 following a white police officer's murder of George Floyd i n Minnesota. Disproportionate deaths among Black and Hispanic populations during the COVID-19 pandemic also inspired states to reevaluate their health programs.
In Connecticut, communities of color often do not trust health insurers and hospitals, Hendricks said. Local organizations donated approximately $130,000 in grants for Access Health CT to address this problem through the Broker Academy.
After participants "come through this program, they're their trusted brokers. They are from those communities. They know how those communities operate,” Hendricks said. “They're able to relate more to other community residents.”
Most of the 29 people Access Health CT trained last year were minority women, Hendricks said. This year, 52 students will participate in a one-week program next month, she said.
Access Health CT officials have been meeting with students weekly over the last month to educate them about the exchange, the basics of insurance and health disparities in Connecticut, Hendricks said. Brokers have also talked to prospective students about their work, she said. Kaplan Financial Services instructors have offered pointers on how to pass the program.
After they complete the course, Access Health CT pairs students with experienced brokers who mentor them for three months.
Yet relying on working professionals to volunteer their time and expertise has drawbacks, said Jennifer Lovett, who owns Crystal Financial Insurance Services, a brokerage in South Windsor, Connecticut. “They want me to train these people to compete with me,” she said. Lovett declined Access Health CT’s invitation to serve as an unpaid mentor.
The state has not disclosed data on how many policies its first class of graduates sold in their first year. The average health and life insurance agent in Hartford earns an annual salary of $74,356, according to the state.
“They're serving communities that had little to no access to a broker,” Hendricks said. “No access to someone that they can talk to about health insurance, learn about health insurance, learn how to use health insurance. The impact is so much larger than how many people they've enrolled.”
This next round of graduates is poised to enter the health insurance sales market at an advantageous moment.
States paused Medicaid eligibility reviews for nearly three years during the COVID-19 pandemic in exchange for increased federal funding. Connecticut began Medicaid redeterminations this month. Nearly 13%, or 116,000, of the state's beneficiaries will no longer qualify, according to a Modern Healthcare analysis. Agents trained through Broker Academy are positioned to help people from the most difficult-to-reach populations find alternate coverage, such as subsidized exchange policies.