Colorado’s Health Insurance Affordability Programs : Goals to Prioritize and Options to Consider to Create a More Direct Pathway to Health Coverage Colorado Covering Kids and Families
Colorado Covering Kids and Families • Statewide, coalition-based project • Focused on increasing low-income Coloradans’ access to affordable health coverage and high quality health care • Diverse membership of outreach and enrollment professionals, community-based organizations, application assistance sites, and health care providers and advocates
History of The Maze April 2009 The Maze: The Barriers that Keep Colorado’s Eligible Children and Families Out of Medicaid and CHP+ and Recommendations to Create a Direct Path to Enrollment July 2010 The Maze One Year Later: An Update on the Progress to Create a Direct Path to Enrollment for Colorado’s Eligible Children and Families in Medicaid and CHP+ June 2012 Colorado’s Maze to Enrollment in Medicaid and CHP+: Progress Made and Opportunities for Improvement November Colorado’s Progress Toward a Simplified Medicaid and CHP+ Enrollment System: 2014 Update 2014
New Report • First in Colorado to document and examine the eligibility and enrollment process since the implementation of the Affordable Care Act (ACA)
What are Health Insurance Affordability Programs? • Health First Colorado (Colorado’s Medicaid Program) • Child Health Plan Plus (CHP+) • Advanced Premium Tax Credits (APTCs) and Cost Sharing Reductions (CSRs) to purchase a qualified health plan through Connect for Health Colorado
Background • Since the ACA was implemented, Colorado: o Expanded Medicaid (now Health First Colorado) o Began offering new health coverage programs (tax credits and CSRs to decrease the cost of private insurance) o Improved the process for applying for and enrolling in health coverage • Many more Coloradans are enrolled in health coverage
Background • Despite these successes… o 353,000 Coloradans not enrolled in coverage (6.7%) o The application and enrollment process is still complicated o Many Coloradans face barriers when trying to apply for, enroll in, and re-enroll in health coverage
What is in the Report? • Visual and text description of the current pathways individuals and families follow to enroll and stay enrolled in health coverage • Nine goals to prioritize to simplify, streamline, and coordinate eligibility and enrollment processes • Legislative, regulatory, and administrative options to reach each goal for decision makers to consider
Report was Informed by… • 11 focus groups with assisters and their clients in summer 2015 • Surveys completed by CKF coalition members in 2015 and 2016 • Conversations with the CKF Advisory Committee and CKF coalition members throughout 2015 and 2016 • Research conducted by CKF staff
Points on the Path to Health Coverage Awareness of Eligibility the programs Determination Renewal Application Enrollment
Pathways to Health Coverage
Nine Goals to Prioritize 1. Reduce churn and minimize gaps in health coverage 2. Monitor and improve eligibility and enrollment systems 3. Improve online and paper applications
Nine Goals to Prioritize (continued) 4. Improve client correspondence 5. Improve customer service support 6. Improve support for community-based assisters and formalize their role
Nine Goals to Prioritize (continued) 7. Clarify, communicate, and improve renewal processes 8. Improve and expand health coverage options. 9. Better coordinate and align the state Medicaid agency, the Colorado Department of Health Care Policy and Financing, and the state’s health insurance marketplace, Connect for Health Colorado
Short T erm, High Impact Options • Six fact sheets Improve transfer of information between systems and o entities Continue to simplify PEAK o Improve client correspondence o Prioritize the implementation of the integrated support o model Allow assisters to have access to additional information o on a client’s case Improve and integrate training for assisters o
Find the Report Online • Full report • Executive Summary • Fact Sheets • Handouts http://ckf.cchn.org/publications/the-maze/
Questions?
Colorado Covering Kids and Families CONTACTS: Kristen Pieper, Senior Project Manager, kristen@cchn.org Stephanie Brooks, Policy Analyst, sbrooks@cchn.org Liz Tansey, Outreach & Enrollment Coordinator, ltansey@cchn.org http://ckf.cchn.org
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