« December 2013 Issue

Navigating the ACA Rollout with Patience and Determination

For supporters of the Affordable Care Act, October 1, 2013 was a long-awaited day. Finally, three years after passage of the law, enrollment in the state and federal Marketplaces opened nationwide. There was a jubilant feeling among the members of our consumer advocacy community. One advocate reported during the first week of enrollment, “People were just hungry for information: Overnight, the national dialogue switched from ‘Obamacare: Good or bad?’ to ‘Can I get affordable coverage?’ Amazing.” It was a welcome change for everyone in the implementation trenches.

The task of enrolling millions of Americans nationwide felt a bit like being at the base of a mountain, eager to climb but prepared for a long hike ahead. And by now, if you’ve read a newspaper, watched a cable news show, or listened to the radio, you might think you know the whole story of how the climb is going. But this huge undertaking cannot be reduced to only sound bites and news articles. 

The technological difficulties with Healthcare.gov, while disappointing and challenging, did not distract advocates and their partners from their overall mission: reaching out, educating, and enrolling millions of Americans in new coverage options made possible by the Affordable Care Act. As one advocate characterized it: “People were amazingly calm – and grateful, finally, to get straight answers, good-faith efforts to offer logical explanations of difficult policies, and referrals to helpful tools.” 

During October and November, there were many bright spots and developments that revealed a strong demand for quality, affordable health care that people and their families could rely on. States like Kentucky, where Gov. Beshear chose to build a state Marketplace and expand Medicaid, posted high enrollment numbers in the first month. California, Connecticut and Washington State reported huge interest and strong enrollment numbers. Or Oregon, where the state chose to take up a special option combining food stamp enrollment data with Medicaid eligibility, leading to 70,000 people enrolled in health coverage almost overnight. And in New York, where advocates serving as Navigators are collecting stories of how in-person assistance can lead to successful enrollment and satisfied consumers. These successes kept advocates going and reminded them that these same results would soon spread nationwide.

Now, almost two months later, we are seeing both the results of advocates’ patient approach, as well as the outcome of the Obama administration’s “tech surge.” Since October 1, 1.2 million people have gained coverage through the Marketplaces, Medicaid and CHIP. And according to press reports, as many as 56,000 people signed up through Healthcare.gov during the first three days of December. What’s more, new communications research shows consumers looking for insurance from the Affordable Care Act have not been discouraged despite frustrations with state and federal websites. PerryUndem Research conducted extensive focus groups with uninsured individuals and one thing is clear: consumers think being uninsured is worse than dealing with website glitches.

We know that fulfilling the promise of the Affordable Care Act is just beginning. We’re encouraged by what we’re seeing already and hopeful this positive trajectory will continue. Furthermore, from our experience with the 2006 Massachusetts health reform law, we know these final weeks before the enrollment deadline will be critical, and an enrollment surge is likely.

Our advocacy community is strong, and committed to reaching out and educating and enrolling millions of Americans. It’s been a choppy beginning, but we’re seeing evidence that smoother sailing lies ahead.