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The New Orleans Health Department's History of Improving Access and Partnering with Community-Based Organizations Helped Outreach and Enrollment

• With 504HealthNet, a private not-for-profit membership organization for the region's community health centers, the New Orleans Health Department led an outreach and enrollment work group.
• The department also made use of public health data and mapping to support its outreach efforts. It conducted both direct and indirect outreach and enrollment, and it leveraged its network to increase enrollment opportunities.

Outreach and Enrollment Efforts Face Challenges at the Individual and Policy Levels

• Individual barriers included the population's low levels of health, computer, and insurance literacy; the cost of insurance; and the time and effort required to enroll.
• When Medicaid was not expanded in Louisiana, a gap in coverage occurred for some people who had previously been able to access coverage through a Medicaid waiver program. Also, about 40 percent of the uninsured would have been eligible for Medicaid under expansion; many of these people seek care primarily through community health centers.

Some Factors Help Those Efforts

• The primary facilitator of these activities is the large network of partnerships on which the health department could draw to enhance outreach and enrollment. Also, although the state did not support expansion of the Patient Protection and Affordable Care Act, residents of New Orleans were generally in favor of the act. The city is generally "pro-Obama" and, as a result, supported implementation activities, such as the enrollment events.