Nebraska will receive far less money than many states to promote the Oct. 1 startup of its health insurance marketplace.
An Associated Press study found that the state is expected to receive about $1.3 million in federal money for marketing, advertising and outreach, ranking the state 39th in per-capita spending.
The majority of the $1.3 million will be used by federal community health centers, such as OneWorld in South Omaha and the Charles Drew Health Center in northeast Omaha, to hire staffers to help people use the online insurance exchange. Some $600,000 may go to one or two organizations in Nebraska next month for “navigators,” or people trained to help others enroll for health insurance through an exchange.
Organizations such as AARP Nebraska, Nebraska Appleseed, Interchurch Ministries of Nebraska and others are planning their own efforts, without federal aid, to get the word out as a coalition called Enroll Nebraska.
Iowa is expected to receive about $2.1 million in federal money. That would place Iowa at No. 40 in per-capita federal spending for marketing of the Affordable Care Act insurance sign-up program.
Iowa, however, has asked the federal government if it can redirect $3.5 million in federal money to a media campaign, town hall information sessions, a phone line manned by information specialists and other marketing efforts, said Tom Alger, spokesman for the Iowa Insurance Division.
In Nebraska, it may be likely that people will learn about the marketplace by word of mouth or through a door-to-door campaign, at neighborhood association meetings and forums, from literature or speakers in churches and libraries, or even from a telemarketing effort.
Enroll Nebraska is considering those and other activities.
Nancy Thompson, chief executive officer of the Health Center Association of Nebraska, said people need to know what their options are.
“It's a historic moment, and we need to be able to meet the task, but we are woefully under-resourced to do that,” said Thompson, who works with Nebraska's six federal community health centers. “So we'll do the best we can, but it's going to be a big task.”
Nebraska's six community health centers will use a total of $678,562 to hire 13 workers to help people enroll. Those efforts for the most part will serve the patient population of the health centers. In Iowa, $1.47 million will go toward 26 workers to do that job.
Reaching out to those who don't use community health centers is another task, said Ted Boesen, chief executive officer of the Iowa Primary Care Association.
“It's a great opportunity, but it's a huge challenge,” Boesen said. The Primary Care Association works with Iowa's health centers and is the counterpart of the Health Center Association of Nebraska.
Mark Intermill, advocacy director of AARP Nebraska, said many AARP members have Medicare and won't be directly affected by the online marketplaces.
“But they do have families,” Intermill said, and therefore AARP will play a big role in getting the message out. AARP and Nebraska Appleseed will send representatives to central and western Nebraska next month to meet with officials of public health departments and other agencies about their outreach efforts.
James Goddard of Nebraska Appleseed said the representatives will provide examples of presentations and fact sheets that can be used at forums.
Intermill said Enroll Nebraska has no money for advertising in major media outlets. But the group hasn't given up on finding a foundation or private funder that might provide that kind of money. Public education, he said, is the goal.
“My observation,” he said, “is that there is not a lot of working information out there about the Affordable Care Act — what opportunities it poses for individuals, especially those who don't have insurance now.”