Outreach for equity: Learning from enrollees on California state–based exchange

Background: Covered California, the state's ACA Marketplace, supports nearly 1.8 M enrollees in accessing affordable, quality commercial insurance.After ten years, there is limited research on the clinical and health-related social needs (HRSNs) of marketplace enrollees, partly due to their short duration of coverage. 1,2,3Recognizing this gap, Covered California surveyed enrollees to learn about HRSNs and barriers to care.Objectives -Understand the HRSNs and care barriers faced by Covered California enrollees -Inform Covered California program development and population health investments Methods:We used a multi-modal approach, deploying an email survey and conducting phone interviews with current enrollees.The survey was sent to 107,440 enrollees with chronic conditions (99,313 in English and 8127 in Spanish).A subset was targeted for phone interviews.Response rates aligned with those of similar surveys and campaigns.Chi-Square tests, z statistics, and logistic regressions were used to identify statistically significant relationships between food insecurity and benefit preferences among respondents with chronic conditions.Results: Survey Response Rates. Email Survey Results:Enrollees who endorsed food insecurity were 12 times more likely to prioritize grocery support as their most desired monetary benefit than other types of benefits (p < 0.0000).