Americans who get married, seek citizenship or lose jobs may find themselves invited to sign up for Obamacare by supporters trying to sustain momentum for the program as political attacks mount in its off-season.
By mid-April, the end of the first year’s official enrollment period, more than 8 million Americans gained coverage under the health law, beating the government’s own estimates. While standard enrollment won’t start again until Nov. 15, as many as 3 million people whose jobs or lives change in ways that affect their insurance may sign up immediately.
Supporters are seeking to dip into that group before the next enrollment begins. The goal: Keep their positive message alive at the grassroots, while offsetting any potential losses to enrollment totals from those who find alternative coverage, or simply drop out.
“Part of our challenge is making sure we are using every avenue to educate,” said Anne Filipic, the president of Enroll America, which is helping organize the off-season initiative. “It kind of becomes more challenging if it’s not on the front page of the newspaper every day.”
Her group hopes to intercept potential customers at places including churches or courthouses to communicate that not everyone has to wait until November for a health plan under the Patient Protection and Affordable Care Act, she said.
It’s an effort that may help make up for expected losses to the program from people who don’t complete their enrollment by paying their premiums, or who find jobs, become eligible for Medicare or otherwise obtain alternate coverage, said Rick Curtis, president of the Institute for Health Policy Solutions.
If the freshly eligible can’t be reached, “by the next open enrollment period, there will be fewer people enrolled than there are now, and that would be a significant problem,” Curtis, whose group is located in Washington, said by telephone.
An erosion of total enrollment may mean that remaining customers are sicker and older, causing insurers to propose larger premium increases, Curtis said. States that run their own insurance exchanges may have trouble raising money to pay for their operations if customers leave, he said.
It would also be an opening for Republican opponents who say the law is unworkable.
Democratic senators running for re-election this year in states that tilt Republican will have to defend their votes for the law, Senator John Thune of South Dakota, the third-ranking Republican in the chamber, said yesterday in a floor speech.
“They own it, they own that vote,” Thune said. “Yet they’re trying to figure out how to spin it to the American people so it’ll come across different from the reality that the American people are experiencing.”
The government hasn’t reported how many people have signed up for health plans since the last enrollment period ended and it won’t estimate how many may enroll because of changes in their insurance, Aaron Albright, a spokesman for the U.S. Centers for Medicare and Medicaid Services, said in an e-mail.
That supporters must continuously advocate for the law is a sign of its unpopularity, said Chris Neefus, a spokesman for Americans for Prosperity, the advocacy group founded by conservative billionaires Charles Koch and David Koch.
“Is it going to be in perpetuity here that we have to continue to press people onto this system, catch them in public spaces, at courthouses, and push them onto a government system that clearly isn’t that enticing a deal for people?” Neefus said in a phone interview.
Becky Abel of Lakeland, Florida, signed up for a health plan after her husband, Tom Abel, lost his job in May. Tom Abel’s former employer, Jacobs Engineering Group, had previously provided the couple’s insurance.
‘Any Old Time’
“I didn’t know there was an enrollment period,” Becky Abel, 56, said in a phone interview. “I just assumed we could sign up any old time.”
“A little overwhelmed” by the federal enrollment website, healthcare.gov, Abel said she called the United Way of Central Florida, an Enroll America partner, where a counselor helped her sort through options. She selected a Humana Inc. plan with a premium of about $450 a month, she said.
One of the government’s concerns is that people new to health insurance who don’t use their coverage this year might not renew for 2015, figuring the cost wasn’t worth it, said Cara James, the director of the Office of Minority Health at the Centers for Medicare and Medicaid Services. To that end, the administration announced an effort June 16 to encourage newly insured people to find doctors and make appointments, called “From Coverage to Care.”
Minorities and low-income people are especially likely to be unfamiliar with health insurance, James said. Her office is in charge of the Coverage to Care program.
“Insurance is not something you just use when you get sick,” James said in a phone interview. “They can use it to stay healthy as well.”
Contacting new citizens at naturalization ceremonies in Florida cities and in South Texas has “been one of our most successful tactics,” Justin Nisly, a spokesman for Enroll America, said in an e-mail.
At a conference sponsored by Filipic’s group, James encouraged enrollment workers to distribute what the government calls a “road map” for using health insurance. The document explains insurance concepts such as in-network and out-of-network care, and advises Affordable Care Act customers about how to find a doctor and schedule appointments.
Churches, particularly those with minority congregations, have been “one of our real great access points to reach the uninsured,” Filipic said. The African Methodist Episcopal church in an April 8 letter urged its members to promote the law and its programs, calling it “a godsend and major blessing to millions of Americans who did not have or could not afford health care.”
Filipic said her group is working with churches this summer, asking pastors to mention the law in their sermons or invite Enroll America organizers to “do a quick spiel about what’s available.”
“In that way we’re reaching maybe 400 people in an hour who not only themselves have a high likelihood of being uninsured, but also likely know a lot of friends and family who can benefit as well,” she said.
In Miami and other cities, Filipic’s group has begun to work more closely with small-business owners. An Enroll America organizer, Volma Volcy, persuaded restaurants and other small firms in Miami’s Haitian community to place drop boxes in their businesses, where customers interested in health coverage can leave cards with their contact information.
“People were skeptical about it last year,” Volcy, who is Haitian, said in a phone interview. “Now that they have family members or friends who have been able to sign up and tell them about how it works, they’re almost waiting for November.”