The role of librarians in helping patrons with their health insurance needs rose in significance following former United States President Barack Obama’s speech at the annual conference of the American Library Association in 2013. He requested help from librarians in assisting the public with navigating the Affordable Care Act (ACA) and the Health Insurance Marketplace. Few studies have explored how librarians connect with their communities to improve access to health care. This session will discuss the results from semi-structured interviews with librarians who undertook outreach efforts to promote enrollment in the health insurance marketplace and provide information about the options their patrons have for obtaining affordable health insurance coverage. The examples shared will provide concrete strategies for undertaking health insurance outreach efforts. This session will highlight vetted information resources and tried-and-true approaches to connecting patrons to health insurance coverage.

1. Librarians Build Healthy
Communities by Connecting Patrons
to Health Insurance Coverage
Emily Vardell, PhD
School of Library and Information Management
Emporia State University
@evardell
#KLAC2019

2. Calls to Action
• At the 2013 American
Library Association
Conference, Obama
requested assistance from
librarians in ACA
implementation.
• The Institute for Museum
and Library Services:
• “ethical mandate rather than
a government regulation” to
assist with providing a “face
to government rules and
resources”

3. Calls to Action
http://www.ala.org/pla/initiatives/connectingyoutocoverage

4. Health Insurance Marketplace Enrollment (in
millions)
8.1
11.7
12.7 12.2 11.8
2014 2015 2016 2017 2018
https://www.kff.org/state-category/health-coverage-uninsured/

5. • “The success of health system
reform will depend in large part
on the capacity of individuals,
families, and communities to
make informed decisions about
their health.”
• -Department of Health
and Human Services

6. Outline
• Results from interviews with librarians who ACA undertook outreach efforts
• Concrete strategies for undertaking health insurance outreach efforts.
• Favorite health insurance information resources

8. Why? Lack of Awareness
• "I think a lot of people didn't even know
it still existed and what the deadlines
were, because the government wasn't really
promoting anymore." (Participant 4)
https://www.kff.org/health-reform/issue-brief/data-note-further-
reductions-in-navigator-funding-for-federal-marketplace-states/

9. Why? Lack of understanding
• “We do get a lot of phone calls … looking for information [such] as:
• ‘when is the deadline’
• ‘did I miss something’
• ‘who can I talk to’
• ‘I saw a flyer in the library about you are having a nurse coming and talking about diabetes and
healthcare’” (Participant 6)

10. Librarian roles
Administration
Programming
Outreach
Social Media

11. Funds
Boosting social media
Enrollment events and speakers
Newspaper ads
Printed materials
Radio ads

12. Funds: Boosting social media
• "We shouldn't be afraid to go ahead and boost
posts even though it's cost money, because you know
being a small rural library that's always a fear. It
is successful. We did see a success with that
portion." (Participant 2)
• "Yes, probably some of our programming and
something like that, as well as the census, the health
insurance information stuff, other big issues that
arise as needed.” (Participant 2)

13. Funds: Enrollment events
• “We tried to pick times in the evenings
and in the weekends, because those are the
two times when we seem to get the most
people. Saturdays sometimes you are doing
something with your families, you'd rather
do it in the early evenings, so we choose the
time we are most busy and we looked at
some of the times based on our surveys.”
(Participant 1)

14. Funds: Printed materials
• "They basically had a template. We put the
links on our library. For the print media, we
use their basic template and then we added a few
things about programming that was coming up
around that, but it was a great way to start and
I don’t need to create anything." (Participant 4)

15. Funds: Radio ads
• "We took the script that the PLA information had provided. We tweaked it a little bit to
be more specific of what we wanted. Most of the PSA was not so much about enrolling
but to draw attention to the fact that your public library serves on this expanded role that
you don't necessarily know about." (Participant 5)

16. Surprise about library involvement
• "I think a few of them were surprised that we were offering something like this, because
usually you don't really see in the smaller libraries and the more rural libraries... I know
some rural libraries they have the resources and they've got the connections and they always
have this cool stuff happening, but in my experience, it is sort of a novelty to be able to
bring in other organizations to help." (Participant 3)

17. Surprise about library involvement
• "She is our bookkeeper. She's in the library all the time. She saw a lot of the information around
on social media. She works as a contractor, so she always had many questions about how to access
insurance, how to choose the best insurance plan, but she didn't know where to go. She was the one
of the people who really expressed surprise that she was used to coming to the library to do her
work, check out books or whatever. She had no idea that this is what one of the roles that the
library can play. She was one of the people who came when the navigator presented, they had a
conversation after the presentation. She later made an appointment with the navigator at her office.
Next time she was in the library. She came in to tell us that the navigator was credibly helpful,
and she was able to choose the best insurance plan with the navigator's guidance. She felt like she
finally understood how this all worked… I think even if you impact one person and have a success
story like that, it is successful.” (Participant 5)

19. Reach out to HR reps
• “I met with as many of the HR reps from those companies as I could to try to explain to
them how important this is and how it's important that their employees are given those
options. It was very time-consuming. Mostly when I went to the companies and dropped off
posters, I would ask if their HR person was available and then did a quick five-minute
talk ... And [would] say, ‘Hey, this is a cool thing we're doing.’ That was interesting, but
I think they were receptive and just kind of shocked that the library was coming and
dropping off posters or anything." (Participant 3)

20. Reference approach
• "Reference department staff, they were
just guiding people like a tax filing. They
don't do it for them, but they show them
where to go, how to do it, where to do it."
(Participant 6)

21. Success of program
• "It was just really satisfying to know that you did something for the public and help
somebody. And it was also a way to connect with the community." (Participant 4)

22. Using health insurance
• "Knowing the information and understanding why are two different things. I think having
a medical health insurance coverage is one thing versus where to go and get it right. So why
they have to bother to get to it and why they should be proactive and use this." (Participant
6)

23. @evardell
#KLAC2019

24. https://www.healthcare.gov/

25. • Time for a check up!
• Es Hora Para Su Chequeo Anual
• Special Enrollment Period: What
That Means & Why It Matters
• Factsheets: How Millennials use
access and use health care
• What Exactly is Preventative Care?
https://younginvincibles.org/

26. • Project Outcome is
a FREE toolkit designed to
help public libraries
understand and share the
impact of essential library
services and programs by
providing simple surveys and
an easy-to-use process for
measuring and analyzing
outcomes.
http://projectoutcome.org

27. From Coverage to Care (CMS)
https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/from-coverage-to-care.html

28. Learn how to use your insurance card
• From Coverage to Care (CMS)
• English (PDF, 7.2MB)
• Arabic / ‫ية‬ ‫عرب‬ ‫ال‬( PDF, 64KB)
• Chinese / 中文 (PDF, 145KB)
• Haitian Creole/Kreyòl Ayisyen (PDF, 58KB)
• Korean / 한국어 (PDF, 97KB)
• Russian / Русский (PDF, 63KB)
• Spanish / Español (PDF, 160KB)
• Vietnamese/TIẾNG VIỆT (PDF, 61KB)
https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/from-coverage-to-care.html

29. Tip: You can print/order copies
https://marketplace.cms.gov/outreach-and-education/order-coverage-to-care-materials.html

30. Promoting Healthy Communities: Libraries
Connecting You to Coverage (PLA)
• Checklist to apply for or re-enroll in health insurance – 8.5x11 (PDF)
• Sign up for a 2020 health insurance plan brief poster – 8.5x11 (PDF)
• 5 Steps to Get Started with Health Insurance brief poster – 8.5x11 (PDF)
• Special Enrollment Period explained brief poster – 8.5x11 (PDF)
• Medicaid and CHIP Enrollment brief poster – 8.5x11 (PDF)

31. Become a Champion for Health Insurance Coverage

32. Checklist for a Health Insurance Education
and Enrollment event
http://www.ala.org/pla/sites/ala.org.pla/files/content/initiatives/openenrollment/190219-pla-
connecting-you-to-coverage-guidelines-and-checklist.pdf

33. Advocating for health at your library
Showcase the vital roles of the library and educate the public about the critical health
issues your community faces:
• Be a health advocate for your library with this presentation template (PPTX)
• Use community health data to plan your services, displays and collections
• Get the community active by hosting yoga, 5ks and other events
• Promote nutrition through cooking classes, summer meals for kids, and partnering
with farmers markets
• Support staff to get educated about their own health and wellness

34. Just Plain Clear
https://www.justplainclear.com/en

35. Just Plain Clear
https://www.justplainclear.com/en

36. Favorite Resources
• HealthCare.gov
• Young Invincibles
• Project Outcome
• From Coverage to Care
• Connecting You to Coverage
• Just Plain Clear

37. Libraries and the
Affordable Care Act
The MLA Guide to Answering
Questions about the
Affordable Care Act

38. Questions?
Emily Vardell, PhD
evardell@emporia.edu
@evardell
#KLAC2019