Barriers to Enrollment in Health Coverage in Colorado

Barriers to Enrollment in Health Coverage in Colorado

Laurie T. Martin
Nazleen Bharmal
Janice C. Blanchard
Melody Harvey
Malcolm V. Williams
Copyright Date: 2014
Published by: RAND Corporation
Pages: 75
  • Cite this Item
  • Book Info
    Barriers to Enrollment in Health Coverage in Colorado
    Book Description:

    Although, under the Affordable Care Act, Colorado has expanded Medicaid and also now operates its own health insurance exchange for individuals, there continues to be a diverse mix of individuals in Colorado who remain eligible for but not enrolled in either private insurance or Medicaid. This report explores the reasons for this and makes recommendations on how Colorado can strengthen its future outreach and enrollment efforts.

    eISBN: 978-0-8330-8947-2
    Subjects: Health Sciences, Business, History

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iii)
  3. Table of Contents
    (pp. iv-iv)
  4. Figures
    (pp. v-v)
  5. Tables
    (pp. vi-vi)
  6. Summary
    (pp. vii-viii)
  7. Acknowledgments
    (pp. ix-ix)
  8. Abbreviations
    (pp. x-x)
  9. 1. Introduction
    (pp. 1-8)

    One of the central goals of the Patient Protection and Affordable Care Act (ACA) is to extend health insurance to the uninsured and improve access to affordable health care. Two of the main ways that ACA extends health care coverage are through the expansion of public insurance and modifications to the private health insurance market, including the establishment of health insurance marketplaces or exchanges. Although the ACA is national in its scope, much of the critical action is taking place at the state level.

    ACA expands public insurance by allowing states to extend Medicaid eligibility to individuals with an income...

  10. 2. Barriers to Health Insurance Coverage Across Colorado
    (pp. 9-19)

    To help guide our thinking on the why individuals in Colorado were not enrolling in health insurance coverage, we developed a high-level framework (See Table 2.1.). This framework suggests three key steps in the pathway toward insurance coverage: awareness of health insurance coverage and eligibility, the decision to enroll, and successful navigation of the enrollment process. Within each step, there is an interaction between the individual (e.g., his or her skills, experiences, and beliefs) and the oprational, or structural, aspects of outreach and enrollment that are related to the Marketplace or conducted by individuals providing enrollment assistance (e.g., messaging, Connect...

  11. 3. Special Populations
    (pp. 20-22)

    In addition to the more universal barriers to health insurance coverage identified across Colorado (Chapter Two) and region-specific barriers outlined in Appendixes A–H, one of the objectives of this study was to identify unique barriers or challenges specific to special populations. Though additional information and detail on these populations and barriers can be found in the appendixes, we summarize some of the key findings here.

    Latino populations are lagging behind the rest of the country in Medicaid and private insurance enrollment through the Marketplace (Shartzer, Kenney, Long, Hempstead, & Wissoker, 2014). Conversations with Latinos, and in particular those living...

  12. 4. Recommendations and Conclusions
    (pp. 23-28)

    This project sought to understand why individuals were not enrolling in health insurance in Colorado. To accomplish this, we spoke with a wide array of individuals—both uninsured and newly insured individuals—as well as community stakeholders across the state. These interviews and focus groups revealed a number of barriers, and, in most cases, challenges arose when there was a disconnect between (1) what was being provided to consumers in terms of messaging, processes, and infrastructure and (2) the needs and abilities of consumers to understand health care coverage and to find, access, and navigate resources to help them with...

  13. Appendix A. Barriers to Health Insurance Coverage—Metro Region
    (pp. 29-33)
  14. Appendix B. Barriers to Health Insurance Coverage—North Central Region
    (pp. 34-37)
  15. Appendix C. Barriers to Health Insurance Coverage—Northeast Region
    (pp. 38-41)
  16. Appendix D. Barriers to Health Insurance Coverage—Central Region
    (pp. 42-44)
  17. Appendix E. Barriers to Health Insurance Coverage—Southeast Region
    (pp. 45-48)
  18. Appendix F. Barriers to Health Insurance Coverage—West Central Region
    (pp. 49-52)
  19. Appendix G. Barriers to Health Insurance Coverage—Northwest Region
    (pp. 53-58)
  20. Appendix H. Barriers to Health Insurance Coverage—Southwest Region
    (pp. 59-61)
  21. References
    (pp. 62-65)