Drew Altman, the CEO of the Kaiser Family Foundation, (and I might add a fellow Brandeis alum), wrote a very interesting perspective piece on the last minute sign up for the Affordable Care Act and what that says about the state of the health insurance literacy of those needing insurance the most.

The point Altman makes is that the people signing up at the last minute in California have either

  • Never had insurance
  • Haven’t had it for two years or more
  • Many don’t have access to the internet. 

Shocking as that may be, it does present a roadmap for how states will have to work moving forward to make sure the people who need insurance the most understand their options. 

As he says: For the long term, harder to reach uninsured, enrolling will never be as simple as shopping on Travelocity or Amazon.com. Reaching them will take hands on community based outreach.

Connecticut understood that early on and in the last few weeks set up storefront offices staffed with real people who could walk individuals through the process of signing up and answer questions at the same time.  There were estimates that as many as 10,000 people took advantage of those storefronts and reported it was a fairly quick process. 

We often like to talk about how buying health insurance is like buying a car and how it’s fairly easy to go online and find out what you need to know to compare models and prices and make a choice.  What this enrollment process indicates though, is that health insurance is different.

There is clearly an argument to be made for making all of the information necessary to make a choice as transparent as possible, many people need a real person to talk to, to answer questions in real time and to help them think through their options. 

As one woman who signed up at the Connecticut storefront said in an NPR story: “”It makes it easier for me to converse with another person. When I'm on the computer and everything, it's confusing. Frustrating. Especially this time. I had a stroke, so at this time in my life it's a little difficult.”

Clearly, reaching those who need insurance the most will take a hands-on approach supported by a campaign that reinforces the message about why health insurance matters for individuals and small business.

As we write the next chapter of health reform, this is an important perspective to keep in mind.