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Enrollment for Health Coverage with Covered California Starts Nov. 15

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Greenlining Institute Urges Californians to Learn About Their Options as Covered California Builds on Last Year’s Success

BERKELEY, CALIFORNIA – Following a successful launch which brought affordable health coverage to 1.1 million Californians, Covered California – the health insurance marketplace created by federal health care reform – is about to begin its second open enrollment period, beginning Nov. 15 and running until Feb. 15.

“Health care reform has been a major step forward for communities of color in California, but many still have not taken advantage of the new options that are available,” said Greenlining Institute Health Policy Fellow Anthony Galace. “We’re happy to report that Covered California has made improvements this year that should make shopping for coverage easier.”

Among other things, Covered California has:

  • Improved the customer experience by collaborating with community-based organizations to help with outreach and enrollment. There are more than 6,400 Certified Enrollment Counselors and more than 12,000 Certified Insurance Agents to help consumers choose and enroll in the best coverage option.
  • Added over 250 additional bilingual staff in its service centers in order to better serve Californians whose English is limited. The need for improved language assistance was a major issue highlighted by Greenlining last June in its analysis of Covered California’s first year.
  • Provided $16.9 million to 135 community organizations that will help people enroll and also provide post-enrollment and retention assistance, providing a more streamlined “one stop shop” for California residents who need assistance with their health coverage.
  • Added dental coverage for children to all 2015 Covered California plans.

Galace noted that renewal for the 1.1 million Californians enrolled last year has already begun. “Those who like their current plan can keep it without doing anything,” he explained, “but since some prices have changed , it’s a good idea to check your options.”

The Greenlining Institute has assembled important information for Californians seeking health coverage at http://greenlining.org/issues-impact/bridges-to-health/affordable-care-act-information-for-californians/


Revamped Covered California Campaign Seeks Greater Minority Enrollment

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In the six months following the end of the first Affordable Care Act enrollment period, officials with the Covered California insurance exchange analyzed data to revise strategies aimed at removing more Californians from the ranks of the uninsured. The result of the analysis is Covered California's 2015 Community Outreach Campaign, a multi-pronged effort that will employ more than 200 community-based organizations, or Navigators, to work within their constituencies to provide personalized enrollment assistance.

Many of the Navigator groups represent African-Americans, Asians and Latinos, groups Covered California is hoping to enroll in greater numbers beginning in mid-November. The community outreach effort that includes $14.6 million in Navigator grants is being launched in conjunction with a $46 million advertising campaign that is heavily focused on minorities.

The combination of targeted advertising through minority media outlets and community partnerships is key to increased participation according to Covered California Executive Director Peter Lee.

"We are getting ready to roll out the implementation of the Affordable Care Act, building on the experience of last year's first open enrollment to seek to get every Californian covered," Lee said. "To do this we want to build on the partnerships we developed a year ago that made California the leader in the nation in expanding coverage of the Affordable Care Act.

"During the first open enrollment period, more than three million Californians got coverage either through Covered California or were newly covered through Medi-Cal. In California we've reduced the rate of uninsured from 22-percent to 11-percent. That's good news but it's not enough," Lee said. "We want to keep working together in every community in the state until every Californian gets insurance and keeps it. We are optimistic we will be well on that path during the second round of open enrollment."

Lee's optimism isn't shared by everyone. Critics of the initial six-month open enrollment effort claim Covered California did not do enough to target minorities, African-Americans in particular.

Forty-five-percent of the new advertising budget will be spent targeting Latinos, who represent 40-percent of California's population, but were underrepresented among new health insurance enrollees.

A nine-percent advertising allocation has been set aside for African-Americans, who comprise six-percent of the state's population, but were similarly underrepresented among enrollees.

From October 2013 through March 2014, 1.4 million Californians signed up for coverage. With nearly 31,000 signing up, African-Americans represented only 2.2-percent of new enrollees.

"We're looking at other data to see where we did a great job or not so great of a job," Lee said. "Within Covered California about five-percent of subsidy-eligible people are African-American. About four-percent of our enrollment was African-American. But we still want to lean in and double down.  If you look at the Navigator grants we specifically looked out and said who can we add who is anchored in the African-American community that can show they know that community and can reach out effectively and bolster education and enrollment efforts?"

Dr. Brownell Payne, whose Los Angeles-based Crenshaw Health Partners organization received $300,000 in Navigator funding, says the raw enrollment numbers may not give an accurate picture of African-American participation because they don't factor in enrollment in Medi-Cal, California's low-income health coverage assistance program.

"When we talk about enrollment among African-Americans, we're not just talking about Covered California, we're talking about Medi-Cal," Payne said. "Where we operate a significant portion of our community has Medi-Cal. So while the Covered California numbers may have been lower, the Medi-Cal numbers have been huge. With every insurance enrollment we make in the African-American community we will enroll two to three people in Medi-Cal because a lot of people didn't know that they were eligible."

"We invested heavily in reaching the African-American community and the data we have shows that we did a pretty good job," Lee said. "Among the previously uninsured, whether they get it through Covered California or Medi-Cal or through a job, about 61-percent of the previously uninsured got insurance, whether you're African-American, Latino, Asian or White."

The new marketing campaign that includes television, online, radio and print advertising is specifically designed to attract more minority participation by increasing awareness.

One challenge for Covered California and its partner organizations is how to convince African-Americans to sign up for coverage despite reportedly high-levels of awareness about the Affordable Care Act and the Covered California insurance exchange.

Results from a University of Chicago tracking survey show that in May and June 2013, prior to the first enrollment period, awareness of the Covered California insurance exchange among African-Americans was less than 10-percent. By February 2014, the enrollment mid-point, African-American awareness had risen above 80-percent due to advertising and marketing efforts. The survey also reported more than 50-percent of African-Americans had medium to high levels of exposure to the advertising campaign.

Based on the results, Covered California concluded, on average, 40-percent of consumers with high levels of exposure enrolled in a health insurance plan.

Yet, despite higher than average levels of exposure and awareness, African-Americans represented only 2.2-percent of the 1.4 million Californians signing up for coverage during the initial six-month enrollment period.

Payne says misinformation is another factor that may be preventing African-Americans from signing up in greater numbers.

"There are a lot of barriers in the African-American community, and unfortunately part of those barriers are old myths," Payne said. "We had a lot of Brothers and Sisters come up and say, 'We're not going to enroll in Obamacare because they put a chip in your wrist and they can track you for the rest of your life.'"

Conspiracy theories aside, Payne and other Navigator organizations will have to deal with more practical issues like communicating the merits of insurance to people who have never participated in the health care system or whose first insurance policy began last year.

"Part of our purpose in running the ads is to remind people who are not used to having insurance not to cancel because they didn't use it because insurance is there in case really bad stuff happens, as well as for preventive care," Lee said.

"We also  have a lot of people who have been used to relying on the county. So they say, 'Why should I enroll? I might get a $95 penalty, but i'll just go to the county," Payne said. "But what they don't understand is that penalty will increase every year. And the worst possible penalty of not having coverage is if you get in an accident and you don't have coverage."

When the new enrollment period begins November 15, organizers will have only three months to sign-up new enrollees and convince those currently covered to renew or make changes to their existing plans.

Both Payne  and Lee are optimistic about enrollment prospects and point to the strategy of relying on grassroots partnerships as a primary component.

"In the African-American community they trust us and we're in the community moving things forward," Payne said. "Now it is a matter of them gaining trust in the system. A big part of gaining that trust is in-person enrollment. In our center they can sit down and talk to us and gain the trust.

“We've taken care of the low-hanging fruit," Payne said. “ but there are huge numbers in the African-American community who qualify for subsidized enrollment, so we expect the enrollment numbers to be much higher than they were before.

Donna Brazile Announces Democrats for Public Education

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Addresses 3,500 members of the American Federation of Teachers

LOS ANGELES — Addressing more than 3,500 members of the American Federation of Teachers at its national convention, Democratic strategist Donna Brazile announced the formation of a new group that she will co-chair called Democrats for Public Education, which will focus on uniting the vast majority of Democrats, who believe in the promise of public education.

In confronting her political opponents, Brazile asserted, “The very premise of ‘market-driven education reform’ rests on the fallacy that the public school system is in crisis, and that the only solution is to let the market pick winners and losers.”

She expressed the desperate need for classrooms to focus on "educating character, teaching skills, creating an environment of dialogue and inquiry, establishing a community from a diversity of cultures, nurturing potential and empowering people in the pursuit of happiness."

On Friday morning, AFT President Randi Weingarten remarked on Brazile’s new group. She said, “The promise of America is being undercut by people who devote their fortunes to decreasing our strength, to advancing the politics of division, and to promoting economic policies that redistribute more income to fewer people. And they’ve been aided and abetted by some lawmakers, judges and even some Democrats. Some—like those who call themselves Democrats for Education Reform—mimic the Jeb Bushes and Eli Broads of the world, promoting competition and test-obsession.”

She continued, “But a new group of Democrats is emerging: the Democrats for Public Education, led by Democratic National Committee Vice Chair Donna Brazile, former Michigan Gov. Jennifer Granholm and former Ohio Gov. Ted Strickland, who want to stand up for our students, for our educators and for public education.”

As the weekend progressed, delegates listened to elected officials, including Gov. Jerry Brown, Los Angeles Mayor Eric Garcetti and U.S. Reps. Judy Chu, Michael Honda and Mark Takano, as they shared their ideas on how to fight back against divisive politics and lopsided economic policies, and fight forward on behalf of students, families and communities.


New Report: Covered California’s Big Enrollment Numbers Mask Problems

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Serious Issues Hampered Outreach to Limited-English Californians

BERKELEY, CALIFORNIA – Covered California, the state health insurance exchange created under the Affordable Care Act, deserves credit for strong enrollment numbers in its first year but must act to correct serious deficiencies in its outreach and enrollment efforts, a new report finds. The Greenlining Institute study, Covered California’s First Year: Strong Enrollment Numbers Mask Serious Gaps, to be released June 26, follows up on Greenlining’s 2011 analysis of changes facing Covered California, iHealth: How to Ensure the Health Benefit Exchange Reaches all Californians.

“Covered California exceeded expectations for enrollment and did many things right,” said report co-author Jordan Medina, Greenlining Institute Health Policy Fellow. “But when we spoke to enrollment counselors and educators, we found real problems. Millions of Californians do not speak English well, but materials in other languages were often in short supply or simply nonexistent, and some of what did exist was badly translated.”

Key findings of the report, based on interviews with staff at outreach and education grantee organizations and certified enrollment counselors in Los Angeles and Fresno Counties as well as surveys filled out by ordinary Californians, include:

#The demographics of those who enrolled in private insurance plans roughly mirrored the demographics of those eligible, but Californians with limited English proficiency were seriously underrepresented. Eighty percent of enrollees in private insurance plans spoke English as their primary language, even though 40 percent of those eligible for coverage were limited-English proficiency individuals.
#Educators and enrollment counselors consistently cited problems with cultural and linguistic issues. Covered California’s website was fully functional only in English and Spanish (with the Spanish section coming online late), some materials were poorly translated and hard to understand, and translated materials that did exist were often in short supply. Educators and counselors described having to either create their own materials (in violation of rules) or having to give out English language materials and hope that “someone would be able to translate it for them.”
#As Greenlining had predicted in iHealth, lack of high-speed Internet access was a problem in some communities.
#To improve its performance next year, Covered California must:

*expand on the elements that worked, including social media outreach and the network of certified enrollment counselors;
*make sure all outreach and enrollment materials are translated into the 13 most widely spoken languages in California;
*hire a director of diversity and cultural competency to ensure that all communities are targeted appropriately, cultural and linguistic issues are dealt with, and that translations are understandable for the target population; and
*make sure outreach and enrollment activities are better coordinated and seamless, and that those doing this crucial work get adequate funding to do their jobs properly.


Housing for Vets and Public Access Top Ballot – Will Voters Turn Out?

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Updated nonpartisan website guides voters this primary season

SAN FRANCISCO — On June 3, California voters will cast ballots that will impact housing for veterans and public access to government meetings and records. They’ll also choose the top two candidates for a handful of offices including governor, lieutenant governor, attorney general and others. The newly updated nonpartisan California Choices (www.californiachoices.org), a clearinghouse for state voter information, is available to help walk voters through the process.

“If the 2012 primary is any indication, voter turnout could be low—even historically low,” said F. Noel Perry, the founder of the nonpartisan nonprofit organization, Next 10, which presents California Choices in partnership with the Institute of Governmental Studies at the University of California, Berkeley. “We hope that providing voters with clear, concise information will encourage them to get to the polls.”

California Choices examines the two statewide propositions – Prop. 41 and 42 – that are on the ballot this June, providing information about the measures in a highly accessible, one-stop-shop format. Prop. 41 would authorize $600 million in bonds to provide multi-family housing to homeless and at-risk veterans. Prop. 42 would require local governments to comply with state laws providing access to public meetings and records.

The site’s “Endorsements” table shows how nearly 20 groups of all political stripes would vote on both ballot initiatives. The interactive site also allows users to save their votes using the new “My Votes” feature. Voters can then access their voting preferences at any time from another device, including from a smart phone at the polling place. Users can also share their votes with family and friends via email or Facebook.

“Low voter turnout is very simply bad for our democracy. We’re arming Californians with information so that they can become more engaged in the political process,” said Jack Citrin, Director of the Institute of Governmental Studies at UC Berkeley.


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