Navigating health insurance can be complicated. Luckily, enrollment assisters spend their days helping people disentangle the web of applications, document updates and eligibility requirements involved in gaining or maintaining coverage. With tens of thousands of people across the Commonwealth currently renewing their MassHealth membership as part of the ongoing redetermination campaign, the need for enrollment assistance has never been greater. The MassHealth and HCFA-led Certified Application Counselor (CAC) program was conceived to fill this need and create sustained enrollment capacity within twenty-three of the original forty-two community-based organizations (CBOs) involved in the MassHealth redetermination outreach campaign.

When the CAC project began in May 2023, the expectation was for each CBO to hire and train two new CACs, which would significantly boost enrollment capacity in the fifteen Massachusetts communities with the highest rates of MassHealth coverage.

Through June and July, in collaboration with HCFA and MassHealth, our partner CBOs hired and trained dozens of new CACs, with CACs officially beginning enrollment work in August. Now, four months after launching the project, our twenty-three CBOs have produced 102 new CACs, essentially doubling expectations. This is the first time enrollment capacity in CBOs has expanded to this degree.

Across all 23 organizations, CACs host over 735 office hours – time when members can receive enrollment assistance – and 60 scheduled enrollment events per month. These events are held at Councils on Aging and homeless shelters, specifically serving populations whose applications tend to be the most complex: immigrant communities, the homeless population and the over-65 population. The need for assistance is profound. For example, the Brazilian American Center recently assisted 89 families in a single day between their three CACs, and several organizations regularly visit hotels housing Haitian migrants to help the new entrants apply for coverage.

Members value enrollment assistance in and from their own communities through trusted organizations. The new CACs speak over half a dozen languages, including the three most spoken by MassHealth members besides English. One CBO reported that non-English speaking members, “were initially hesitant due to language barriers but were overjoyed when they realized we could communicate with them in their native tongue.” Likewise, CBOs feel empowered and better able to serve their community members. An additional CBO reported being able to educate their community members on their MassHealth plans, ensuring they received the care they were entitled to. This model of sustained capacity for assistance within CBOs is unique and is one HCFA is very proud of. While the MassHealth redetermination campaign is slated to officially end in March 2024, the enrollment assistance fostered through this project now belongs to the community.

Emma Boucher is a program associate at Health Care For All.