ACA ENROLLMENT AND VOTER REGISTRATION FOR HEALTH CENTERS AND OTHER NONPROFITS

1. ACA ENROLLMENT AND VOTER REGISTRATION FOR HEALTH CENTERS AND OTHER NONPROFITS Presented by Nonprofit VOTE Fair Elections Legal Network National Association of Community Health Centers

2. About us Nonprofit VOTE partners with America’s nonprofits to help the people server participate and vote. We are a hub for nonpartisan voter engagement resources for the nonprofit sector. Nonprofit VOTE is a partner of the National Association of Secretaries of State for the nonprofit sector. Find more about our mission and partners on our website: www.nonprofitvote.org About

3. Today’s presenters Marc Wetherhorn Senior Director of Advocacy and Civic Engagement, National Association of Community Health Centers Robert M. Brandon Co-Founder and President, Fair Elections Legal Network Who

4. Registering Voters During ACA Implementation Robert Brandon President Fair Elections Legal Network August 21, 2013

5. Two State Implementation Structures • 17 states are directly handling enrollment in Health Exchanges and for Medicaid • CA, CO, CT, DC, HI, ID, KY, MD, MA, MN, NV, NM, NY, OR, RI, VT, WA • National Voter Registration Act (Motor Voter Law) Compliance Required except in MN and ID • Other states are letting the federal government run the health exchanges. Healthcare.gov application portal will mention voter registration

6. NVRA Compliance Due to offering public assistance through enrollment of benefits, 15 states are required to comply with the NVRA. Secretaries of State will designate health exchanges voter registration sites (CA, VT, NY, CT) -Citizens should be asked if they are registered. If “no,” they must be asked if they’d like to register during enrollment and be offered help Colorado claims to be exempt through their unique structure. (Minnesota and Idaho are exempt because they had EDR when NVRA passed.) Federal enrollment portal will have a registration link

7. Assisting with Registration • If your state is not NVRA compliant, you may still offer registration when assisting enrollment • Basic Requirements: • 18 Years of Age • US Citizen • A resident of the jurisdiction (often at least 30 days) • Meet Registration Deadline for your state (generally 30 days before election), but some states have same day registration during early voting or on Election Day • For more on voter registration requirements for your state, visit www.fairelectionsnetwork.com

8. Third Party Registration Regulations • States vary widely on requirements for third party registration organizations, with some being completely unregulated and some having requirements such as: • Mandating receipts for registrants • Training requirement (on line or in person) • Turnaround time to turn in completed registration forms: • 10 days in Virginia, 48 hours in New Mexico • For guidance on third party regulations in your state, visit www.fairelectionsnetwork.com

9. FELN/NACHC/NPV Training Module • Beginning in October, community health centers will have access to a training module on conducting registration during ACA enrollment.

10. Training Module Contents • Registration requirements for your state • Third party registration regulations • Best practices for conducting voter registration drives at health centers • Scripts with the most effective outreach for voter registration during enrollment • Access to staff with expertise in voter registration • Community Health Vote dedicated voter registration portal

12. ACA Enrollment and Voter Registration at Health Centers and Other Service Providers August 21, 2013 Presented by Marc Wetherhorn Senior Director, Advocacy and Civic Engagement National Association of Community Health Centers

13. Why Offer Non-Partisan Voter Registration? • Elections matter to the future and the health of our clients • The populations least likely to vote are OUR clients • Health centers and other social service providers have a trusted relationship with their clients • Because we CAN make an impact “The vote is the most powerful instrument ever devised by man for breaking down injustice and destroying the terrible walls which imprison men because they are different from other men.” • Lyndon B Johnson

14. Nonprofits CAN increase voting among their clients, constituents, and staff Results from NonProfit Vote – Track the Vote Project 2012 • The clients and constituents engaged by nonprofits were markedly more diverse, lower income, and voter turnout among those contacted by nonprofits was 74%, six points above the 68% turnout rate for all registered voters • Nonprofits were particularly effective at increasing voter turnout among traditionally underrepresented groups and closing participation gaps. • Nonprofit voters outperformed their counterparts across all demographic groups studied. • See more at:http://www.nonprofitvote.org/evaluating-the-impact-of-nonprofits-on-voter-turnout.html#sthash.EcQY7K3p.dpuf

15. Results from NonProfit Vote’s Track the Vote 2012

16. Results from Community Health Vote 2012

17. Results from Community Health Vote 2012

18. Results from Community Health Vote 2012

19. The Opportunity Presented by the ACA The upcoming implementation of the Affordable Care Act (ACA) will bring 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.

20. Understand and Think Through the Process • Most people will not “wander in” to enroll. They will be contacted (probably more than once) and will need to be reminded to bring documentation • Applications assistance is a service of the agency for it’s clients. So is Voter Registration • The application process, at least at the beginning, is likely to be separate from the plan selection process • Applicants will need to fill out one online form already • Application and plan selection assistance will be one-on-one • The health center or other agency is likely already a trusted source, so we have a unique opportunity to provide the additional service of assisting in voter registration

21. The Question is at the End of the Application Process Application for Health Coverage & Help Paying Costs (Short Form)

23. 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

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

25. 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: ours is at http://www.saveourchcs.org/register-to-vote.cfm • 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.

26. NACHC, FELN and Nonprofit VOTE Will Provide Support • An Online Training Module for Enrollment and other staff • Legal information on state and federal requirements • Online Registration portal (to create one for your agency contact Amanda Brown at Rock the Vote: amanda.brown@rockthevote.com) • On the ground, in person training and technical assistance in as many places as resources will allow

27. 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

28. Have Questions or Need Assistance Marc Wetherhorn National Association of Community Health Centers mwetherhorn@nachc.org 540-942-3862 Bob Brandon Fair Elections Legal Network rbrandon@fairelectionsnetwork.com 202-331-0114 George Pillsbury NonProfit Vote gpillsbury@nonprofitvote.org617-357-8683