Massachusetts health care reform: Supporting local communities overcome barriers to health care

Massachusetts Health Care Reform law provided $7 million over the first two fiscal years for outreach and enrollment grants granted to local health and human service organizations. The program, EOHHS Outreach, Enrollment and Access to Care Grants was developed to support the overall goal and mission of health care reform – ensuring that all Massachusetts residents have access to and are enrolled in affordable and quality health care programs. The grant program offered residents direct assistance to overcome health care barriers. While health reform law significantly increased the number of individuals eligible for subsidized health insurance programs, Massachusetts residents faced many significant challenges including negotiating the complex programs and individual requirements, additional layers of bureaucracy and managing the detailed, time consuming enrollment processes. To address these challenges, health workers offered needed one-to-one assistance to individuals and families, many from culturally and linguistically diverse communities who encountered many prior health access inequities. One of the roles of health workers, acting as a policy "interpreter" for members of the community is well documented. During the first two years, thousands of individuals received assistance each month to enroll and retain insurance. Qualitative and quantitative data will be presented documenting the importance of funding for community based education and assistance when implementing health care reform law. Based on the experiences of State, academic and local grant partners and the specific accounts of participating health workers, policy considerations will be discussed including implications for national health care reform.