Improving Engagement with the New Mexico Health Insurance Exchange
The Patient Protection and Affordable Care Act (ACA) has given millions of Americans new access to health insurance, but this does not automatically guarantee that they will be able to take advantage of their state insurance marketplace to get coverage. Rural, low-income, and/or minority communities face particular barriers to participation. To fulfill the goals of the ACA and increase health insurance coverage nationally, consumers need to be made aware of their state’s marketplace and the opportunities it provides. They also need easily accessible support to be informed when selecting and enrolling in a health plan.
These challenges were especially acute in New Mexico, a rural and expansive state with a culturally diverse population, many of whom experience poverty and low literacy. In October 2015, beWellnm, New Mexico’s public-facing marketplace, commissioned AIR and its research partners, Lovelace Scientific Resources and local consultants, to conduct an assessment to:
- Fully understand why subpopulations of New Mexicans who are eligible to receive financial subsidies have not enrolled in health insurance; and
- Develop actionable recommendations that beWellnm can use to tailor outreach communications and support to each subpopulation to improve its rate of enrollment.
Key Findings and Recommendations
The data collection process included a literature review, interviews, and focus groups. Using this information, the researchers identified key challenges that rural New Mexicans faced in learning about beWellnm and enrolling in a plan. These findings corresponded to two major themes: effective, tailored communication; and outreach, enrollment structures, and support. Therefore, their recommendations were also organized into these two categories:
Tailor Outreach Communications to Each Subpopulation
- Focus outreach on positive messaging of interest to uninsured New Mexicans with less emphasis on the tax penalties for being uninsured.
- Provide easily accessible and detailed information about what a tax credit and cost-sharing subsidy means, the process for applying to receive a subsidy, and where people can go to find out if they qualify.
- Develop innovative approaches to reach out to the subsidy-eligible uninsured through local news broadcasts, ethnic media (local and internet radio stations and newspaper), the internet, text messaging, email, and phone.
- Engage people whom the uninsured trust or access for medical care as advocates for becoming insured.
Improve Outreach and Enrollment Structures and Support
- Assess consumer-facing informational and enrollment resources and assistance to identify and correct interfaces that stop the uninsured from moving forward to enrollment.
- Adopt the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care.