application process, there is a movement toward electronic applications and links to allow applications through Internet portals. Privacy and security standards are in place to ensure that the consumer’s information is protected.

Consumer Engagement

The enrollment superhighway is predicated on the notion that consumers will be engaged in the process and have the information they need to make decisions about coverage. However, there is a large gap between where states are today and where they need to be to achieve the envisioned enrollment superhighway, Weiss said. One of the key challenges relates to how consumers experience and engage with enrollment systems.1 Most state systems are very antiquated; their systems are paper-based and not integrated. The burden is on the individual to go from agency to agency in order to enroll in programs for which they are eligible. Many people entering these systems are technology-savvy and are accustomed to technology-enabled environments. They are using their cell phones to order products online and to download music. Individuals of all races, ethnicities, and economic backgrounds are increasingly accessing digital information through smart phones and other means. According to the Pew Research Center’s Internet and the American Life Project (, 35 percent of American adults use a smart phone, and a quarter of them primarily use their phones to download information from the Internet. Latinos and black Americans are as likely, and in some cases more likely, to have a cell phone and are more likely to use their smartphones for these types of interactions. While an increasing number of Americans are relying on modern technologies, states have not yet engaged individuals using these tools.

Enrollment Challenges for States

With eligibility expansions under the ACA, states will have to accommodate a high volume of applicants. In addition, the characteristics of the new applicants will differ from those who have traditionally accessed public programs. The expanded pool of applicants will include employed and middle-income populations. These clients will have different expectations for customer service. Additional challenges will arise when addressing the needs of a much more transient population. The increased eligibility levels and the absence of the categorical eligibility requirements will result in greater access to programs on the part of homeless people and


1 For more information on challenges to enrollment, see Weiss and Grossman, 2011.

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