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
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
TODAY’S PRESENTERS
Robert M. Brandon
Co-Founder and
President,
Fair Elections Legal
Network
Marc Wetherhorn
Senior Director of
Advocacy and Civic
Engagement,
National Association
of Community Health
Centers
Who
Registering Voters During ACA
Implementation
Robert Brandon
President
Fair Elections Legal
Network
August 21, 2013
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
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
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
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
FELN/NACHC/NPV Training
Module

Beginning in October, community health
centers will have access to a training module
on conducting registration during ACA
enrollment.
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
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
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
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-ofnonprofits-on-voter-turnout.html#sthash.EcQY7K3p.dpuf
Results from NonProfit Vote’s
Track the Vote 2012
Results from Community Health Vote 2012
Voter Turnout in the 2012 Election
80%
75%
75%
70%
68%
65%
60%
55%
50%
Overall Turnout
CHC Turnout
Results from Community Health Vote 2012
Voter Turnout by Race
80%
78%
74%
73%
75%
71%
70%
68%
64%
65%
60%
57%
54%
55%
50%
Asian & Other
Black
Overall Turnout
White
CHC Turnout
Hispanic
Results from Community Health Vote 2012
Voter Turnout by Income
79%
80%
75%
74%
72%
73%
70%
64%
65%
60%
55%
53%
50%
Less than $25k
$25k - $49k
Overall Turnout
CHC Turnout
More than $50k
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.
Understand and Think Through the Process
1. 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
2. Applications assistance is a service of the agency for it’s
clients. So is Voter Registration
3. The application process, at least at the beginning, is likely to
be separate from the plan selection process
4. Applicants will need to fill out one online form already
5. Application and plan selection assistance will be one-on-one
6. 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
The Question is
at the End of the Application Process
Application for Health Coverage & Help Paying Costs (Short Form)
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. Integrate the registration message into the outreach
message
3. Have simple materials explaining and encouraging
registration available and throughout the site
4. Create a VR resource team: one or two people at the
center trained to answer questions as a resource for
Outreach & Enrollment workers.
5. 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: 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.
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
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
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.org 617-357-8683