Community Health Vote 2014 ACA Enrollment and Voter Registration at Health Centers January 22, 2014

THE RULE to Remember May Not Support or Oppose a Candidate for Public Office

The Rules: Dos and Don’ts DO Voter Registration Voter Education Distribute Sample Ballots, Guides Co-sponsor Candidate Forums Educate the Candidates Remind People to Vote Help on Election Day: Recruit Poll Workers Support or Oppose Ballot Questions DON’T XEndorse a candidate for office XGive resources to candidates XRate candidates on your issue XTell people how to vote

Why Offer Voter Registration Elections matter to the future of health centers and the health of our clients The populations least likely to vote are OUR clients Health centers have a trusted relationship with their clients Having more of our clients (& staff) as voters dramatically changes the perception of our advocacy power Because WE CAN make an impact: between 910,000 and 3 million votes were lost due to registration problems in 2008, a modest improvement over the year 2000, when between 1.5 million and 3 million votes were lost for the same reason.910,000 and 3 million votes were lost

Results from Community Health Vote 2012

The Opportunity Presented by the ACA The implementation of the Affordable Care Act (ACA) is bringing millions of Americans into Community Health Centers and other social service agencies. It offers a unique opportunity to integrate voter registration into health insurance enrollment services. Many health centers and other agencies already offer ongoing non-partisan voter registration assistance as part of their Medicaid and WIC application and renewal process to comply with the National Voter Registration Act. We will now have a chance to offer this same service to millions more people. We can implement the same voter registration process whether it is required by the NVRA or not.

Challenges and Objections The application and the enrollment process may already be long and confusing now we add voter registration: One more thing for staff to do Enrollment, not registration is the priority More questions for assisters/navigators to answer One more form for the patient to fill out Why register Will they be willing to fill out one more form Turning in the forms Someone on staff has to make sure this is done Others – we’ll find out

Overcoming the Challenges 1.Make the registration process simpler and faster 2.Have simple materials explaining and encouraging registration available and throughout the site 3.Create a VR resource team: one or two people at the center trained to answer questions as a resource for Outreach & Enrollment workers. 4.Provide ongoing training & Technical Assistance to enrollment and other staff on how to ask about voter registration and the process itself

Making it Easier and More Efficient  Treat VR as another service you are offering, not as some unrelated activity. Ask more than once.  Use a simple voter registration interface:  Include VR in your outreach message and advertise it throughout the site so they are expecting it: “When you come into the health center to apply for insurance we can also help you become a registered voter or update your registration”  Have a system for collecting and submitting completed forms.

Making the transition to voter registration – “The next question asks about registering to vote.” “Another important service we offer is helping you register to vote or update your registration. Your being a voter really matters to your health care and your health center. I can help you quickly register to vote or update your registration right now.” Or start with this question - “Can I update your voter registration?” This has proven more effective than just asking “Do you want to register to vote?” If the person says they’re registered, be sure to ask - “Have you moved recently?” Many people move and need to update their voter registration or they will be unable to vote. Making the Ask

State Registration Tools Each state has unique requirements for voter registration and voting State pages at CommunityHealthVote.net offer state-specific resources that will help you register patients to vote CommunityHealthVote.net Three main areas to know: – Registration requirements – How to handle and submit applications – Frequently asked questions

Highlights of the Registration Guide

State Q&A You may receive specific questions when registering patients to vote. Each state page has a Q&A document with answers specific to your state for: – Convicted felons – Victims of domestic violence – Homeless voters

For more information voting issues visit or

Overcoming the Challenges Consider having your client apply online after completing the Marketplace Application, but prior to moving into plan selection. Consider having your client apply online after completing plan selection in the Marketplace, while you’re printing out other documents they’ll need to take away. Offer a paper application if the client is not interested in using the internet to register to vote and let them know you’ll make sure it gets to the county clerk’s office. Let the client know that they’ll receive a voter registration card in the mail after their application is processed by the county clerk.

Elements of Success Organizational Commitment – Board and staff understand the importance Individual Champions – someone responsible who WANTS to make it work A plan for implementation Support from Community Health Vote, FELN and NonProfit Vote

Feedback is Critical This is effort is for the long haul, not just for the first open enrollment period. There will be problems, questions and glitches along the way. The way the states and the federally facilitated exchanges view voter registration and implement NVRA compliance will evolve. We need to hear from you Are you integrating VR into the application and enrollment process What success/problems are you having What help/training do you need

For More Information or Questions Marc Wetherhorn