Expanding Health Care Coverage

Grantee Name

Multiple Grantees

Funding Area

Expanding Health Care Coverage

Publication Date

October 2015

Grant Amount

Multiple grants totaling more than $2.1 million

Grant Date:

July 2013–December 2014


With the advent of health reform, there was a high need for direct assistance and face-to-face support to help individuals complete health insurance enrollment applications.

When the ACA was passed 2010, it was clear that achieving the promise of health reform would not be easy, however. Many people were unaware of the opportunities ahead and unprepared to take advantage of its benefits. Compounding this information deficit, a majority of the uninsured individuals eligible for free or low-cost insurance coverage had low education levels, low incomes, and limited access to computers and online enrollment tools. Approximately half of New Yorkers who were uninsured and would qualify for either Medicaid or subsidized private insurance had a high school diploma or less. Given these challenges, there was a high need for direct assistance and face-to-face support to enroll New Yorkers in health insurance. New York State launched a multipronged strategy to engage uninsured residents and help them enroll in coverage

To complement the State’s efforts and enhance its impact, NYHealth decided to fund an enrollment network of organizations that would reach individuals likely to be uninsured across New York State, focusing on three important populations: low-wage workers; immigrants; and lesbian, gay, bisexual, and transgender (LGBT) individuals. Through a Request for Proposals process, NYHealth awarded grants in 2013 to 19 organizations across New York to launch the Enrollment Network, a statewide initiative to conduct outreach and education to uninsured residents and help them enroll in health care coverage.

Outcomes and Lessons Learned


  • Organized community events, such as health fairs or neighborhood fairs, to reach and inform prospective enrollees about the benefits available to them and conducting eligibility screenings at events when feasible;
  • Partnered with community or public resources (e.g., libraries, community colleges, government social service agencies, job centers, health centers, hospitals) to obtain on-site access and set up stations to offer eligibility screenings and enrollment and outreach services to their clients;
  • Used their organizations’ programs to share information about the enrollment services they offer;
  • Engaged hard-to-reach populations, particularly those that were likely to uninsured and eligible for enrollment;
  • Translated, prepared, and distributed brochures to target populations; and
  • Educated prospective enrollees about potential out-of-pocket expenses (e.g., premiums, coinsurance, copays, deductibles), cost-sharing discounts, and tax credits to subsidize these costs.


  • Conducted individual enrollment services, either face-to-face or by phone, on-site or off-site;
  • Assessed individuals and enrolling them into a public insurance program (e.g., Medicaid, Family Health Plus) or a qualified private health plan on the Marketplace;
  • Assessed individuals for eligibility of available tax credits to subsidize monthly health insurance premium costs; and
  • Offered enrollment services during nontraditional hours, as determined by the needs of the target population.

The Enrollment Network developed a range of creative outreach and education methods and enrolled thousands of New Yorkers into coverage, with the enrollment rate accelerating over time. Through this initiative, NYHealth learned many lessons about the implementation of health reform in New York State and what it took to successfully enroll individuals into health insurance.

Read the full report.