Open Enrollment: One Step Closer to Coverage for All

Nov 2, 2015, 9:00 AM, Posted by

Let’s build upon the success of the Affordable Care Act with this year’s open enrollment.

A pediatrician makes a home visit to check on an infant patient.

Open enrollment is here again—the annual opportunity for Americans to find and enroll in a health plan through or their state-based health insurance marketplace. In three short years, millions of Americans have gained access to health plans that cover important services like doctor’s visits, prescriptions, hospital stays, preventive care, and more. As a doctor, I’ve seen the difference health coverage can make in the lives of families. Quality, affordable health insurance means new access to care—care that can have a huge impact on health, equity, financial security, and a better quality of life. It moves us closer to a Culture of Health, where people can access care when they’re sick and when they’re well, making prevention the priority.

Real Progress.

Since the implementation of the Affordable Care Act in 2013, an additional 17.6 million individuals have enrolled in health insurance. Through marketplace plans, Medicaid and the Children’s Health Insurance Program (CHIP), and private health plans, more Americans are now covered, bringing the rate of those without insurance to historic lows. The Centers for Disease Control estimated an uninsurance rate of 9.2 percent as of August, which is the first time a survey found these rates in single digits.

The Robert Wood Johnson Foundation (RWJF) recently conducted research with those enrolled in marketplace plans and found that 75 percent are satisfied with their health plan and more than 8 in 10 are satisfied with the doctors and services covered by their plan. They’re also using their coverage. That same study showed that 8 in 10 have used their insurance for services like prescriptions, check-ups and more. That’s real progress.

We’re Not Done Yet.

Even as the number of uninsured declines, we know there is more work to do. Cost is a significant barrier to coverage for many of the remaining uninsured. It will be important to continue targeted outreach to make sure that they know their options for health coverage while also thinking through solutions that can help bring more of the uninsured into coverage.

We need to spread the word. We know from a recent study with the uninsured that nearly half had not yet gone to their marketplace to explore their options. We need to let people know that open enrollment is here (November 1 through January 31); that many people can get financial help to pay for their plan; that free, in-person help is available to enroll; and as plans and premiums change every year, it’s worth it to check out your options and shop around.

We must close the coverage gap. Until all states expand Medicaid, there is a segment of uninsured, frequently the most vulnerable in our society, who remain without any affordable options. We must continue to promote the importance of health insurance for all Americans, study the impact in states that have chosen to expand Medicaid, as well as work toward the goal of expansion in every state. We need to ensure that no matter your income or location, you are guaranteed a path towards affordable, quality coverage.

We will keep our eye on results. What is the short and long-term impact of health insurance marketplaces on peoples’ coverage and health? Through Health Reform Monitoring Survey, we continue to assess factors such as health coverage, health care access, affordability, and health status, to provide actionable insights moving forward.  

Together, We Can Realize a Culture of Health

The Foundation has invested in making quality, affordable health coverage available to more Americans for more than four decades. We are on our way to the day when being healthy means more than just treating illness. When life circumstances don’t dictate someone’s ability to access affordable coverage. I believe these are goals we can achieve to bring us closer to a Culture of Health in America. It’s going to take hard work, continued policy analysis, and honest conversations about what’s working and what we need to do better. Let’s continue to work together to ensure more people gain coverage and put it to use. Let’s fully realize what having coverage means for the health of everyone in our society. 

John Lumpkin

John Lumpkin, MD, MPH, is senior vice president and director, targeted teams for the Robert Wood Johnson Foundation.