This is a photo of Pedro Lopez asking how long it will take to sign up for insurance at the Access Health CT store in New Britain.
Pedro Lopez, 43, asks about the wait time at the Access Health CT store in New Britain earlier this year. He was hoping to sign up for health care coverage. Arielle Levin Becker / The CT Mirror file photo
Pedro Lopez, 43, asks about the wait time at the Access Health CT store in New Britain earlier this year. He was hoping to sign up for health care coverage. Arielle Levin Becker / The CT Mirror file photo

Three foundations plan to pay for about 35 people to conduct “shoe leather” outreach to help Connecticut residents sign up for health care coverage during the second round of open enrollment under Obamacare, which begins Nov. 15.

The workers are intended to supplement a sign-up effort by the state’s health insurance exchange, Access Health CT, that critics worry won’t be enough to reach the remaining uninsured.

During the previous enrollment period, which began last fall, Access Health used federal and foundation funding to run an outreach program that included 239 “in-person assisters” from community organizations, who publicized the health law and helped people sign up.

But exchange officials said the results were uneven. Overall, about 8 percent of people who signed up for coverage through the exchange did so through an in-person assister, according to a survey of Access Health customers. And a relatively small percentage of the assisters were responsible for the bulk of those sign-ups.

This year’s effort will center on having 20 “outposts” where people can get information and sign up during fixed hours. The outposts will be staffed by 20 to 30 people hired by Access Health and located in libraries, Department of Labor offices and sites run by community organizations in areas with high levels of uninsured residents.

Access Health will also continue to run two storefronts in New Britain and New Haven.

Jason Madrak, the exchange’s chief marketing officer, said last year’s experience made clear the importance of having assistance available during consistent hours throughout the week, in visible and public locations. Last year, some in-person assisters were only available during brief windows of time each week, making it hard for potential customers to meet with them, he said.

Madrak said having set locations will also make it easier for people to find places to get help enrolling, particularly if they don’t have access to a computer. Last year, the exchange had a database people could use to find a nearby assister, but for people without access to technology, Madrak said, “it was almost impossible for them to go and look somebody up in that database.”

But critics of the plan worry it won’t be enough. Alta Lash, executive director of United Connecticut Action for Neighborhoods, said it was hard to imagine the new model would be effective in reaching the uninsured, who she described as being unconnected and unlikely to seek out insurance.

“You are relying, in this model, on people coming to you,” she said Monday, during a meeting of the exchange’s consumer experience and outreach committee.

Madrak said the exchange is meeting with civic and religious leaders in areas with high numbers of uninsured residents so they can help encourage people to go to the enrollment outposts. “It’s a push and pull system,” he said.

While the previous enrollment effort was funded through $2.7 million in federal grants, federal money isn’t available this year. And exchange officials anticipate different challenges: The enrollment period is three months — Nov. 15 through Feb. 15 — instead of six, as it was last time. In addition to trying to find new customers, Access Health now must also try to retain its current customers. More than 50,000 state residents have individual-market health plans that are expected to be discontinued by the end of the year, a potential new group of customers for the exchange. And those who remain uninsured could be harder to reach than those who signed up during the previous round.

The exchange anticipates spending about $353,000 on the enrollment outposts, including staffing, training and items such as signs and tablecloths.

To supplement the effort, the Connecticut Health Foundation, the Hartford Foundation for Public Giving, and the Foundation for Community Health plan to fund about 35 outreach workers who will receive training and support from Access Health. The foundations plan to fund people that were effective assisters during the previous enrollment period.

Elizabeth Krause, vice president of policy and communications at the Connecticut Health Foundation, said they believe in-person assistance is essential to the enrollment system.

“We believe it’s not the only way, of course, that people get enrollment support, but that especially for underserved populations, populations of color, populations with mental illness, in-person assistance is incredibly important and it’s something that we can’t let go of just yet,” Krause said.

The Connecticut Health Foundation plans to provide about 20 organizations with grants of $5,000 to conduct what Krause called “shoe-leather, community-based in-person assistance.” The Hartford Foundation for Public Giving will fund outreach efforts in the Hartford area, while the Foundation for Community Health will fund an effort in the Northwest part of the state.

“It’s limited, but it will get another 35 people out there to help with this very important effort,” Krause said.

In addition to the storefronts, outposts and foundation-funded assisters, people can also sign up for coverage online, through the Access Health call center, through staff at community health centers and hospitals, and insurance agents and brokers.

Arielle Levin Becker covered health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on caregivers from the National Association of Health Journalists. She is a 2004 graduate of Yale University.

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