Expanding Health Care Coverage

Project Title

Increasing Enrollment and Retention in New York’s Public Health Insurance Programs

Grant Amount


Priority Area

Expanding Health Care Coverage

Date Awarded

November 15, 2007







While more than 2.3 million New Yorkers, including 400,000 children, are uninsured, 1.2 million of them are eligible for, but not enrolled in, public health insurance.

A contributing factor to the high number of eligible but uninsured residents—in New York and other states around the country—are the public insurance system of eligibility, documentation, enrollment, and renewal policies, which directly impact a family’s ability to obtain public health insurance. Under this grant, the Children’s Defense Fund-New York (CDF-NY) proposed to increase health insurance enrollment and retention by working in partnership with community-based facilitated enrollers (FEs) through a Public Health Insurance Monitoring Project.

The Children’s Defense Fund-NY (CDF-NY) will work with facilitated enrollment agencies serving New York City, Westchester, and Long Island to identify systems and policy changes that have the potential for boosting enrollment and coverage under public health insurance programs.

Facilitated enrollers have tremendous potential to drive policy and systems improvements through their direct knowledge of the complex enrollment and renewal process. Every programmatic change to New York’s public insurance programs triggers a series of computer, form, notice, and protocol modifications—each with the potential to disconnect clients from the system. Facilitated enrollers know firsthand about these problems. Their potential to inform policy is not realized because each program works in isolation, and the collective experiences from frontline workers are not systematically captured and presented to policymakers.

CDF-NY will work with 18 facilitated enrollment lead agencies serving New York City, Westchester, and Long Island to identify needed systems and policy changes that will boost enrollment and coverage. It will regularly convene staff from these agencies to collect facilitated enrollment experiences and begin to identify emerging issues that negatively affect enrollment and retention. CDF-NY plans to monitor enrollment data and provide training to facilitated enrollers based on areas of need they identify in these workgroup sessions. CDF-NY will use information it gathers from interacting with the facilitated enrollment agencies to bolster its policy advocacy with a “real world” picture of operational barriers to enrollment. A report presenting these findings will be developed to help inform needed policy and systems changes.