In response to the Affordable Care Act’s (ACA) coverage expansions, community-based charity care programs (CCPs) across the country shifted much of their focus away from helping the uninsured access free or low-cost health services and toward helping individuals enroll in health insurance.

This brief, made possible by Kaiser Permanente Community Benefit and the Robert Wood Johnson Foundation, explores the evolution of many CCPs into enrollment-focused organizations, highlighting the major changes that these programs have undergone to adapt to the post-ACA health care environment and to help connect individuals to Medicaid and marketplace coverage. To inform the brief, the Center for Health Care Strategies (CHCS) interviewed staff from six organizations that participated in CHCS’ Charity Care Affinity Group. All of these organizations continue to provide charity care services, but have enhanced their role as enrollment assisters. Common themes revealed during interviews include:

  • Hiring more enrollment assistance staff;
  • Educating individuals about how to use health insurance;
  • Increasing community outreach activities; and
  • Taking advantage of new resources, programs, and partnerships.

These findings may be useful to state policymakers, health care foundations, and community-based organizations as they grapple with how best to connect low-income individuals to affordable health care.