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Consumer Perspectives on Eligibility and Enrollment

This morning, the California Endowment and California HealthCare Foundation shared preliminary findings from a joint study on consumer enrollment methods at a briefing in Sacramento. The study tracks 92 low- and middle-income Californians applying for health coverage using phone, in-person, and online enrollment systems. The study was conducted in four counties, including Los Angeles, Fresno, Alameda, and Humboldt. Some of the preliminary findings are listed below.

What Consumers Want

When applying for coverage, consumers prioritized feeling comfortable in the County office, staff friendliness, up-front cost information, and multiple methods of enrollment (among others). Enrollment method preference varied by income and ethnicity, with high-income individuals preferring online and Latinos preferring County office.

Feedback on In-Person Enrollment

Pros: Ability to ask questions, different languages, handing in paperwork, confidence they completed the process correctly. Cons: Inconvenient (had to skip work), long waits, uncomfortable/unsafe atmosphere, too few Spanish-speaking staff, etc.

Ideas for improvement: Clear signage in County offices (to reduce confusion), shorter wait times in County offices, finish application in one visit, safer/calmer atmosphere, friendly staff, more Spanish-speaking workers, clear next steps.

Feedback on Enrollment by Phone

Pros: Ability to ask questions, quick, convenient, help from informed person. Cons: Too “scripted” (not friendly), limited programs available, not sure about next steps.

Ideas for improvement: This method should be promoted more, consumers should be able to apply for more programs over the phone, friendly workers, explanation of where information is going, more official process, clarity about next steps, closure.

Feedback on Online Applications

Pros: Quick, convenient, can stop at any time. Cons: Not comfortable, too easy (nervous they did something wrong), time consuming to create account, not sure if application complete, difficult to choose a plan.

Ideas for improvement: Simplify process to create account, simplify instructions, allow consumers to apply for additional programs (CalFresh, CalWORKS, etc), give guidance on choosing health plans and identify participating doctors, official acknowledgement of application completion, clarify where participants stand at the end of the application.

Next Steps

In Part 2 of the study, the Foundations will conduct focus groups with eligibility workers and interview County Officials.

More information from the meeting is available here.