Publicly funded family planning providers are well positioned to help uninsured individuals learn about health insurance coverage options and effectively navigate the enrollment process. Understanding how these providers are engaged in enrollment assistance and the challenges they face in providing assistance is important for maximizing their role in health insurance outreach and enrollment.
In 2014, some 684 sites participating in California's family planning program were surveyed about their involvement in helping clients enroll in health insurance. Weighted univariate and bivariate analyses were conducted to examine enrollment activities and perceived barriers to facilitating enrollment by site characteristics.
Most family planning program sites provided eligibility screening (68%), enrollment education (77%), on-site enrollment assistance (55%) and referrals for off-site enrollment support (91%). The proportion of sites offering each type of assistance was highest among community clinics (83–96%), primary care and multispecialty sites (65–95%), Title X–funded sites (72–98%), sites with contracts to provide primary care services (64–93%) and sites using only electronic health records (66–94%). Commonly identified barriers to providing assistance were lack of staff time (reported by 52% of sites), lack of funding (47%), lack of physical space (34%) and lack of staff knowledge (33%); only 20% of sites received funding to support enrollment activities.
Although there were significant variations among them, publicly funded family planning providers in California are actively engaged in health insurance enrollment. Supporting their vital role in enrollment could help in the achievement of universal health insurance coverage.
At the time of writing, Jennifer Yarger was research associate, and Jan Malvin was project director; Claire D. Brindis is director—all at the Philip R. Lee Institute for Health Policy Studies and Bixby Center for Global Reproductive Health, University of California, San Francisco. Sara Daniel is project manager, and M. Antonia Biggs is associate researcher, both at Advancing New Standards in Reproductive Health, University of California, San Francisco.