Press Release: New CSS Report Recommends Leveraging Community Based Enrollment Partners to Stem Coverage Losses

Press Release

New CSS Report Recommends Leveraging Community Based Enrollment Partners to Stem Coverage Losses

1.5 million New Yorkers at risk of losing coverage due to federal cuts to public health insurance programs

A new Community Service Society of New York (CSS) report documents how resourcing community-based enrollment organizations to do targeted outreach and marketing to low-income communities, communities of color and historically uninsured groups can be a cost-effective strategy to maximize the number of New Yorkers who enroll in and renew their health coverage irrespective of where they live or the languages they speak.

Maintaining insurance coverage rates will be a top priority for New York state policymakers in light of federal funding cuts to Medicaid and Affordable Care Act-funded health insurance included in the "One Big Beautiful Bill" passed by Congress in July. An estimated 1.5 million New Yorkers are expected to become uninsured as a result, with another 500,000 transitioning from one form of coverage to another over the next two years.

The new report, "We'll Keep You Covered: How Funding Community-Based Outreach Reduces Coverage Losses in the Face of Federal Policy Changes," offers important lessons to state policymakers. The Keep New York Covered (KNYC) project, spearheaded by CSS, was part of a 14-month insurance renewal campaign by the state, from March 2023 to October 2024, aimed at mitigating coverage losses following the expiration of federal rules under the COVID-19 Public Health Emergency. Under those rules, continuous enrollment ensured that 9 million New Yorkers had public health coverage during the pandemic - either Medicaid, Child Health Plus, or the Essential Plan - and New York secured its lowest uninsured rate ever. Federal Public Health Emergency (PHE) policies expired in 2023, threatening these coverage gains.

The biggest takeaway from the KNYC project was that local community-based organizations (CBOs) can successfully reach and enroll consumers who otherwise may be unreceptive to mainstream communications and marketing efforts. The 36 CBOs in the KNYC project conducted more than 63 million engagements using a variety of mediums. As a direct result of this outreach, 85,132 New York consumers enrolled or recertified their health coverage between March 2023 and October 2024. These groups - immigrant advocacy organizations, neighborhood health centers, local nonprofits and ethnic/faith-based entities - engaged individuals in their primary language, at local community events and through multi-lingual media and social media.

"As New York State continues to navigate the new federal health care landscape, one of the most urgent and overlooked challenges is ensuring that our most vulnerable residents maintain their health coverage," said David R. Jones, CSS President and CEO. "Investing in culturally specific communications and proactive outreach by trusted local organizations that understand the communities they serve is critical. It is not just about language translation. It's about understanding how different communities perceive health, government and bureaucracy. It's about meeting people where they are."

"We want to thank the philanthropic community for funding this project, which proved that funding culturally specific outreach is not just the right thing to do, but the fiscally responsible thing to do," said Elisabeth Benjamin, CSS Vice President of Health Initiatives and co-author of the report. "Because every uninsured person who ends up in the emergency room costs the state far more than a year of preventative and emergent care. Every missed renewal increases the administrative burden on the state. And every gap in coverage leads to worse health outcomes, large uncompensated care burdens for our State's providers, and higher costs down the line."

Return on Investment of the KNYC Project

The state deployed two strategies to retain enrollment numbers: (a) streamlining coverage renewals through the NY State of Health (NYSOH) integrated Marketplace and (b) taking advantage of federal waivers that grant states flexibility in protecting consumers from "procedural" terminations of coverage.

However, the philanthropically funded KNYC project was crucial to the goal of protecting enrollment gains achieved in the post-pandemic period as well as solidifying decades-long progress in reducing disparities in uninsurance rates for many racial and ethnic minorities.

The KNYC project also turned out to be a remarkable return on investment. At a cost of $30 per enrollment, the $2.5 million KNYC project generated a 3,850 percent return on investment. In other words, the KNYC project produced $38.50 in savings for every $1 spent. The project funded 36 CBOs serving 40 counties across five regions: Western New York and the Finger Lakes; Southern Tier and Central New York; North Country and Mohawk Valley; Capital Region and Mid-Hudson; and New York City and Long Island.

Utilizing CSS's nationally recognized "hub and spokes" service delivery model with CSS serving as the funding and administrative "hub" and the 36 CBOs representing the "spokes," the KNYC project offered CBOs a monthly learning collaborative, central data collection and message alignment and advice. As a result, CBOs were able to hone their outreach strategies through peer-to-peer learning and the sharing of best practices.

Recommendations

During the PHE unwind, the role of community-based assistors was especially critical given that 77 percent of individuals who enroll through the NY State of Health Marketplace use assistors for help securing health coverage. Yet, state-funded enrollment programs are not allowed to use grant funding for outreach activities. State policymakers should revise grant guidelines to allow community-based enrollers to use state funding not only for enrollment assistance but also for outreach, education and digital engagement.

The KNYC project demonstrated that these professionals know their communities best. Equipping them with funding and resources to reach marginalized communities before coverage lapses - not just after - is a smart investment.

The Community Service Society of New York (CSS) has worked with and for New Yorkers since 1843 to promote economic opportunity and champion an equitable city and state. We power change through a strategic combination of research, services, and advocacy to make New York more livable for people facing economic insecurity. By expanding access to health care, affordable housing, employment opportunities, debt assistance, and more, we make a tangible difference in the lives of millions. Join us at https://www.cssny.org.

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Issues Covered

Access to Health Care

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