The “No Wrong Door” (NWD) initiative, set to be implemented by the end of next year, is designed to work in conjunction with the Affordable Care Act to move massive numbers of uninsured minorities, including Latinos, into the health insurance system by making enrollment easier. However, NWD was mandated by the ACA to be ready in October of last year. It is a system that would allow consumers, who may ‘knock’ on different doors for health insurance coverage – some of which may not be opened – to be seamlessly routed to the program that best meets their needs.
According to the Connecticut Health Foundation, the “No Wrong Door” initiative would prevent 36,000 people from losing health insurance coverage for at least part of the year. Once fully operational, the ACA with NWD would cut the number of uninsured Latinos in half, according to data, from 21 percent to 10.3 percent.
“Those at the administrative level knew that it would take a long time to implement,” said Elizabeth Krause, vice president of policy and communications at the CT Health Foundation. “I don’t know the extent to which any other state has implemented ‘No Wrong Door’ at this point. I wouldn’t necessarily call it wishful thinking to implement it on time with the ACA.”
The biggest problem with starting NWD is integrating it with often-outdated, older technology programs and services, she said. “The challenge is that Connecticut’s Medicaid program has a legacy of eligibility management systems that are 30 years old, not an updated system in terms of technology,” she said. “Connecticut has received federal dollars to modernize eligibility through Medicaid and talk with Access Health Connecticut as well.”
According to state data, there were about 50,000 uninsured Latino adults shortly before the October launch of the ACA. It’s estimated that with NWD put in place, that number could fall as low as 25,000. While 65,000 of the state’s 338,000 uninsured are undocumented immigrants, they are not eligible for any programs with the ACA. Meanwhile, the Spanish-language version of the Access Health CT website finally launched February 21st, she said.
“Sometimes the consumer just doesn’t know where to go,” Krause said. “The lack of awareness is higher in the Latino population, but it’s the job of the system to reach out to people to help them. People talk about healthcare insurance as a marathon and not a sprint.”
Still, the NWD policy remains an unknown factor for many leaders in the Latino community, who are working with the regional Latino populations to get the word out about the upcoming enrollment deadline at the end of the month. Jose Ortiz, executive director of Hartford’s Hispanic Health Council, said he was unfamiliar with NWD, but added that his council and staff of more than 30 “navigators” are working overtime to handle the people coming into their Hartford offices to sign up for health insurance.
“We’re one of the navigators in the state, and we’re seeing people every day,” he said. “A lot of the people we’re helping don’t have computers at home, and even of they did, it’s a complicated process that takes about an hour to complete. They would still need help even if they had computers.”