mere 6 months before the actual process can begin, there are only questions
regarding the reaching out to consumers.
"I'm getting very worried," says Stan Dorn, a
senior fellow at the nonpartisan Urban Institute who studies outreach and
enrollment for health programs. "Most health coverage expansions have not
reached their target populations very quickly."
According to Ron Pollack, executive director
of the health advocacy group Families USA and a close administration ally, only
$40 - $50 million from federal grants may be available to hire nonprofit groups
to work with consumers.
"That's a pittance compared to what's
needed to make the application process work," Pollack says. "It
doesn't even scratch the surface" even in tandem with privately funded
Enrolling people under a law that few know
anything about was always going to be challenging. Three years after the law's
passage, polls show widespread ignorance about its provisions.
"It's not hard to get sick people to sign
up for health insurance," says Bob Laszewski, a Virginia-based consultant
and former insurance executive. "But it's really hard to get healthy
people to sign up. If we don't get a healthy cross-section, the financial
structure of the ACA unravels," and premiums will skyrocket.
Private foundations, health advocacy groups
and health industry groups have promised to fill in the gaps for Texas and
"I feel like we need a 'Ready, set, go,'
" from the federal government, says Bee Moorhead, executive director of
Texas Impact, a faith-based group, who is hoping that federal grants to pay
nonprofit groups for help will be announced soon.
"In Texas, people have been tapping their
toes and drumming their fingers," she says. "We know we have a big
uninsured population, we know we have a strong faith-based community working
hand-in-hand with the state, and we know we have the ability to get things
done. We need someone to say, 'It's time. Let's do it.' "
Enroll America, an offshoot of Families USA
staffed with tech-savvy former campaigners for Barack Obama, is also hoping to
step up to fill the gaps. The group has 13 employees now and hope to add 300
where the rate of uninsured is high, says President Anne Filipic, a former
White House official.
With only six months left, there's also still
time for the president to "use the megaphone," says Dan Mendelson,
CEO of consulting firm Avalere Health and a former Clinton administration
So far, however, Mendelson says, the
administration has not focused on reminding the public that purchasing health
insurance will soon be "an obligation that everyone has," whether
they like it or not. People need time to come up with the money they will need.
Hannah Punitha (IRDA Licence Number: 2710062
Gold April 2013