With open enrollment in the Health Insurance Marketplace [Marketplace] beginning on Nov. 1, Title V agencies have a unique role to play in connecting uninsured women, children and families to the Marketplace and other coverage options. One of the primary functions Title V staff can serve is coordinating with community partners to get people connected to coverage and care.

Although the Affordable Care Act (ACA) is a national law, successful implementation of the law has required the strong support of state and local advocates. Given the varying laws and policies that existed among the states prior to passage of the ACA, the law has played out differently in each state. As such, outreach and enrollment strategies that work in one state may not be as fruitful in another.

A number of national groups – including Community Catalyst, Families USA and Enroll America – have gathered and shared best practices in outreach and enrollment for states to adopt and adapt for their unique needs. Among these best practices are strategies for closing the information gap and expanding health literacy, investing in outreach, using various forms of technology, easing the enrollment experience by providing one-on-one assistance and establishing statewide and community-level relationships to partner on outreach and enrollment-related activities. Perhaps the most vital of these practices for the Title V community is establishing these critical partnerships.

Community partnerships are essential for maximizing Marketplace enrollment for maternal and child health (MCH) populations. Some of the more common partners Title V agencies engage with include local health departments, federally-qualified health centers (FQHCs), schools, hospitals and consumer advocacy groups.

One example of engagement with a traditional partner comes from Connecticut, where Title V works with school-based health centers throughout the state to conduct outreach and enrollment for the Marketplace as well as for the Children’s Health Insurance Program (CHIP). It is important to note that many of these community-based entities, often FQHCs or consumer advocacy groups, may be receiving Navigator grants from the Centers for Medicare and Medicaid Services to conduct their outreach and enrollment work. However, in order to reach the most vulnerable women, children and families, it is critical for Title V agencies to think outside the box when establishing community partnerships.

Some less traditional partners for Title V to consider engaging in support of open enrollment include faith groups, homeless shelters, tribal councils, multicultural community centers, LGBTQ advocates and social service agencies or nonprofits that work with justice-involved individuals. Such partnerships are working in many states. For example, Washington partners with a statewide consumer advocacy group in which 90 percent of the outreach and enrollment staff are bilingual, in order to meet the language and cultural needs of its population. In Montana, the Department of Health and Human Services’ Women’s and Men’s Health Section collaborates with the Montana Primary Care Association and the state’s Navigator grantees to provide specialized trainings on coverage options for justice-involved individuals. These efforts demonstrate a commitment from Title V agencies to assist hard-to-reach populations as they try to navigate the health care system.

In the transformation of the Title V MCH Block Grant, Dr. Michael Lu, associate administrator of maternal and child health at the Health Resources and Services Administration, emphasized the importance of access to coverage and care through the development of National Performance Measure No. 15: the percent of children age 0 through 17 who are adequately insured. There are 15 jurisdictions focusing on this measure in their block grants. Even if a state hasn’t selected the measure, Title V agencies can engage in partnerships to promote outreach and enrollment in the Marketplace, Medicaid and CHIP. (Note: Eligible individuals can enroll in Medicaid and CHIP year-round.)

AMCHP’s Health Reform Implementation (HRI) team has a number of useful resources for Title V staff related to the ACA, including the Outreach and Enrollment Fact Sheet and Coverage Chart. For more information about how specific NPMs relate to the act, please see AMCHP’s ACA Crosswalk. For specific questions about open enrollment, which ends Jan. 31, please contact AMCHP’s health reform implementation team at scollins@amchp.org.