Using a case-study approach, representatives of the Insure Duluth coalition were interviewed in order to evaluate processes, strengths, challenges and outcomes associated with using a coalition approach to community outreach and enrollment in health insurance via the new state marketplace, which is part of the implementation of the Affordable Care Act. Overall, interview participants cited numerous strengths to the coalition approach as well as technical challenges with enrolling persons in health insurance. They also felt such challenges had the unintended effect of strengthening the relationships between coalition organizations. Community level outcomes were identified as being associated with the coalition’s work. Participants also discussed key contextual factors supporting the coalition. The coalition approach appears to be a promising tactic to increase health insurance access. States can provide funding for and foster policies to assist coalitions expand health insurance access.
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