NEED TO SUSTAIN OUTREACH AND ENROLLMENT SITES IN THE COMMUNITIES by Chip Joffe Halpern

It is time to make the MassHealth/Commonwealth Care outreach and enrollment grants permanent. With the passage of health reform, these grants have been essential to help facilitate enrollments in the new public health insurance plans.

With the implementation of health reform and the health insurance mandate, it is essential that individuals in each community have local access to needed information and to be able to enroll in all public health programs in their own communities.

An historical perspective here may be helpful: Prior to October 1995, Massachusetts residents enrolled in public health insurance programs through local Department of Public Welfare offices, where individuals had designated workers. At the time there were only six categories of MassHealth, but still, individuals found that having relationships with workers helped facilitate successful enrollments.

In an effort to streamline the application process, MassHealth was removed from local offices and put into four enrollment centers (MEC’s) throughout the state. MassHealth became essentially a mail and telephone process.

But since the MassHealth expansion of 1996 and now the passage of health reform in 2006, much has changed. There are now an astonishing 152 categories of public health coverage. The mail and telephone procedure to apply for the increasing complex health coverage programs is now considered inadequate. Reasons include:

• With 152 categories of public health coverage, the public health coverage system in Massachusetts increasingly complex.

• The numbers of individuals now eligible for the variations of MassHealth and Commonwealth Care is greatly increased.

• More than before, individuals frequently need assistance, preferably with a worker with whom they have a relationship, to understand the complicated and frequently confusing eligibility guidelines and successfully complete the application process.

• Many applications need follow-up troubleshooting to insure that individuals are successfully enrolled in programs.

• Individuals also need assistance with the ongoing re-determination process. So not only is it important to enroll residents into these programs, but they also need assistance to maintain their health insurance.

The need for health care outreach and enrollment is not a one or two year endeavor, individuals gain and lose health insurance all the time. Reaching out in the communities and enrolling the diverse residents of Massachusetts in all available health insurance programs will take a sustained effort.

Chip Joffe Halpern
Executive Director, Ecu-Care in North Adams