Affordable Care Act and American Indians: Creating a Culture of Coverage in New Mexico

We are creating a “Culture of Coverage” in New Mexico by providing in-person consumer assistance to Native consumers accessing the NM Health Insurance Exchange. By raising awareness and increasing knowledge, we encouraged a shift in attitudes resulting in more Native consumers acquiring health coverage.  The Affordable Care Act offers many incentives for tribal members to enroll in coverage, but they are exempt from the requirement to have minimal essential coverage in 2014. Many Native consumers do not see the need for insurance believing that the Indian Health Service can provide comprehensive services. We found that when Native consumers understood the benefits of no or low-cost health coverage and had the information necessary to make an informed choice, they were far more likely to apply and enroll rather than seek an exemption from the individual mandate.

Our program was implemented in less than 60 days and during the first four months, resulted in 8,654 outreach encounters with 2,861 individuals receiving one-on-one education regarding new coverage options available through the Affordable Care Act.  These efforts resulted in 674 people applying for Medicaid or enrolling in a Qualified Health Plan through the New Mexico Health Insurance Exchange.

Because of the short timeframe to design and implement our program, we adapted a Results Based Accountability approach to develop our data collection and reporting tools. Due to the success of our program, the New Mexico Health Insurance Exchange has replicated many of our strategies, tools, and processes to improve enrollment activity in other communities.