When you hear the debate about large scale federal programs such as the Affordable Care Act, the focus tends to be on issues related to taxes, states rights, the role of government, etc. Yet what is becoming increasingly clear to me is that once a piece of legislation is passed and a program funded; once the lawsuits have run their course; and in short once the dust has settled, the most critical question is how people will actually take advantage of the initiative.
The Obamacare rollout is the exception that proves the rule. Going into it, policymakers knew that unless a large percentage of uninsured young people signed up for the exchanges, the whole program wouldn't work. To address this, the federal government spent nearly $700 million on "publicity, marketing and advertising..." And it appears to have worked: as of April 19, 2014 over 8 million Americans had selected a plan on the insurance marketplaces (source: CNN)
So now let's talk about what normally transpires. Here's perhaps the most obvious example: with respect to benefits "such as the earned-income tax credit, SNAP, child care subsidies and health insurance...only 5 percent of low-income families use all four of them." (source: NY Times) Why? Simply put, enrolling isn't easy, and many people don't know about the benefits to begin with. And the organizations best position to help these families--nonprofits and government agencies--are chronically underfunded to do the work.
Finally, we turn to the example that got me thinking about this issue. President Obama just announced that he will "use his executive power to expand a program called Pay As You Earn, which limits [student] borrowers' monthly debt payments to 10 percent of their discretionary income." (Source: NPR) So far so good. What got my attention, however, is what NPR correspondent Anya Kamenetz noted in the article: a tiny percentage of those eligible for the program actually take advantage. Why? Student loan borrowers are "either a) unaware of the program or b) have had serious trouble signing up for it."
This is an absolutely essential point. No matter how fantastic the program, it means nothing unless there is funding for outreach and enrollment. What good are public benefits few are receiving? Student loan deferrments few are taking advantage of? Low-cost insurance for which families are not enrolled? Fortunately, the not-for-profit sector is extremely well-positioned to serve these target populations provided they are given the funding they need to do the work. I can't emphasize this enough: unless organizations like us are fully funded, federal programs with the potential to change millions of lives will fail for the simple reason that people can't sign up for something they don't know about and can't access.
The Obamacare rollout is the exception that proves the rule. Going into it, policymakers knew that unless a large percentage of uninsured young people signed up for the exchanges, the whole program wouldn't work. To address this, the federal government spent nearly $700 million on "publicity, marketing and advertising..." And it appears to have worked: as of April 19, 2014 over 8 million Americans had selected a plan on the insurance marketplaces (source: CNN)
So now let's talk about what normally transpires. Here's perhaps the most obvious example: with respect to benefits "such as the earned-income tax credit, SNAP, child care subsidies and health insurance...only 5 percent of low-income families use all four of them." (source: NY Times) Why? Simply put, enrolling isn't easy, and many people don't know about the benefits to begin with. And the organizations best position to help these families--nonprofits and government agencies--are chronically underfunded to do the work.
Finally, we turn to the example that got me thinking about this issue. President Obama just announced that he will "use his executive power to expand a program called Pay As You Earn, which limits [student] borrowers' monthly debt payments to 10 percent of their discretionary income." (Source: NPR) So far so good. What got my attention, however, is what NPR correspondent Anya Kamenetz noted in the article: a tiny percentage of those eligible for the program actually take advantage. Why? Student loan borrowers are "either a) unaware of the program or b) have had serious trouble signing up for it."
This is an absolutely essential point. No matter how fantastic the program, it means nothing unless there is funding for outreach and enrollment. What good are public benefits few are receiving? Student loan deferrments few are taking advantage of? Low-cost insurance for which families are not enrolled? Fortunately, the not-for-profit sector is extremely well-positioned to serve these target populations provided they are given the funding they need to do the work. I can't emphasize this enough: unless organizations like us are fully funded, federal programs with the potential to change millions of lives will fail for the simple reason that people can't sign up for something they don't know about and can't access.
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