Illinois ACA Navigators: An analysis of effective outreach strategies for health insurance enrollment in minority populations

Introduction - The Affordable Care Act (ACA) created a new workforce of navigators whose role includes education, outreach and facilitation of health insurance enrollment by providing culturally and linguistically appropriate services to the uninsured. Navigators focus their efforts on the uninsured who are disproportionately represented in minority populations.   We explore outreach strategies employed during ACA enrollment, highlight changes between the first and second periods and begin to identify their ongoing impact on the insurance rates of minority communities in Illinois.  

Methods - This analysis uses three data sets including navigator demographics, reported performance metrics and a online survey sent to all certified navigators in Illinois in 2014 and 2015. We include quantitative analysis of the type and depth of their outreach, as well as their perceived impact on relevant subgroups amongst the uninsured.  776 (62%) of the certified navigators responded in 2014 and we expect similar rates in 2015.

Results: Initially we find that navigators who employ a variety of outreach activities outperform their peers in ACA enrollment.  Additionally, we find that Navigators who describe the minority communities they serve as either “very or somewhat motivated” are more likely to have higher enrollment success in subsidized Marketplace coverage.  The second enrollment period will be completed in early 2015, and we will compare these findings with the Navigators strategies to reach the remaining uninsured population in year two.

 Implications: This study provides future navigators and outreach workers with important details about best practices, training recommendations and coordinated messaging for work to engage uninsured minority populations.