A flyer left at homes in Hartford as part of Access Health's door-knocking effort to get the word out about open enrollment.
Access Health CT, the state’s insurance exchange, will have limited in-person guidance this year during open enrollment.
Access Health CT, the state’s insurance exchange, will have limited in-person guidance this year during open enrollment.

As coronavirus cases edge up and limitations on in-person gatherings persist, leaders at the state’s health insurance exchange are turning to virtual meeting rooms and online fairs as they try to reach uninsured residents during the annual open enrollment period, which begins Sunday.

Face-to-face meetings have been critical in connecting uninsured people with health plans, subsidies and other services available through the exchange, known as Access Health CT. But this year, even as the state is trying to help an influx of residents who lost their jobs and health coverage, many of the typical avenues for outreach aren’t practical amid a pandemic.

“We have a great deal of concern because we have customers who, since we started, have never engaged with us other than in person,” said James Michel, CEO of Access Health. “Sometimes they don’t trust sending stuff through the mail. Sometimes they don’t trust the computer. So we recognize that as a challenge.”

In a typical year, exchange employees host dozens of people in cities across the state to explain the enrollment process and answer questions. Workers also organized Tupperware-style parties in residents’ homes, gathering people together to talk about insurance and the importance of preventative care. Local businesses held discussions on why health coverage matters.

Patients and workers walk through the lobby at Community Health Services, a federally qualified health center in Hartford’s North End. Many FQHCs will not be able to do in-person enrollment this year. Jenna Carlesso / CT Mirror
Patients and workers walk through the lobby at Community Health Services, a federally qualified health center in Hartford’s North End. Many FQHCs will not be able to do in-person enrollment this year. Jenna Carlesso / CT Mirror

In 2019, the exchange launched a massive door-knocking effort in communities with high rates of uninsured families.

“Many of them were not aware they could get free health insurance, because a lot of people qualify for Medicaid,” Michel said. “If they’re not eligible for Medicaid, they may qualify for subsidies, where plans would be very affordable because of subsidies from the federal government.”

The door-knocking program will not continue this year. But Access Health is still holding in-person appointments on a limited basis. Six enrollment centers – in Hartford, New Haven, Stamford, Bridgeport, New Britain and Groton – will be open to guide people who may not have phone or internet access, or who may prefer to meet face to face. Appointments must be made in advance; walk-ups are not permitted.

Other longtime initiatives are on hold or will shift online. The popular enrollment fairs, which last year drew 1,782 visitors, will be held virtually in the coming weeks. Access Health this month started a series of explanatory sessions, called Healthy Chats, via Zoom (the chats are typically held in towns across Connecticut). At least three more are scheduled for November.

Posters advertising open enrollment will appear at COVID-19 testing sites, flu clinics, pharmacies and supermarkets – locations that have drawn steady crowds during the pandemic. And officials are prepping their call center workers for what could be an increase in phone calls.

Census data from 2019 show there were just over 207,000 uninsured people in Connecticut, or 5.9% of the population. Officials at the exchange do not have a current estimate, given the large number of people who have lost their jobs this year.

Even before the pandemic, low-income families and people of color were more likely to be uninsured here.

The 2019 data show Connecticut residents who identified as Black or African American were 1.4 times more likely to be uninsured than whites. People who identified as Hispanic or Latino were nearly three times more likely to be uninsured. And a family earning between $25,000 and $49,999 was 1.7 times more likely to lack coverage than the average household in the state.

James Michel, head of Access Health CT, has said he is concerned about the segment of Connecticut’s population that remains uninsured. Thomas Breen / New Haven Independent
James Michel, head of Access Health CT, has said he is concerned about the segment of Connecticut’s population that remains uninsured. Thomas Breen / New Haven Independent

Health disparities have worsened during the coronavirus crisis. Black residents are 2 ½ times more likely to die from a COVID-19 infection than whites. The death rate for Hispanics is 67% higher than for white residents when adjusted for age differences.

“This year in particular, it’s going to be challenging,” said Andrea Ravitz, chief marketing officer for Access Health. “If 2020 taught us anything, it’s the crucial importance of reaching as many people as possible.”

Federally qualified health centers, where people can also sign up for plans on the exchange or for Medicaid coverage, are facing the same dilemma. Enrollment specialists often sit down with visitors for an hour or longer, coaching them through the process.

“We can’t have people in a closed office space for an hour and a half,” said Judy Tallman, director of grants and outreach for Community Health Services, a federally qualified health center in Hartford’s North End. “It’s just not practical right now.”

This year, staff at CHS will hand out sheets with information about how to do enrollment over the phone or online, as well as a list of documents that people will need when signing up. Employees will provide guidance by phone if someone gets stuck.

Tallman worries she won’t be able to help as many people get coverage this year. The process already is intimidating for many, and she fears some people might give up without in-person assistance.

“Before, we could book one-on-one appointments – for two hours at a time – and walk them through it,” she said. “We won’t have that personal touch this year, or at least a lot less of it.”

Access Health officials hope the digital events will make up for some of that. One of the Healthy Chats in October netted almost 80 RSVPs. About half of those people showed up for the online presentation, and the other half were emailed a link to view the recorded session. Thirty online enrollment fairs are planned during open enrollment, which runs through Dec. 15.

“We live in a country where, if you don’t have insurance, health care is virtually unaffordable unless you’re wealthy,” Michel said. “That’s why it’s critical for everyone to have health insurance, especially in a pandemic.”

For information or to sign up, call 855-805-4325 or visit AccessHealthCT.com.

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Jenna is CT Mirror’s Health Reporter, focusing on health access, affordability, quality, equity and disparities, social determinants of health, health system planning, infrastructure, processes, information systems, and other health policy. Before joining CT Mirror Jenna was a reporter at The Hartford Courant for 10 years, where she consistently won statewide and regional awards. Jenna has a Master of Science degree in Interactive Media from Quinnipiac University and a Bachelor or Arts degree in Journalism from Grand Valley State University.

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