Table 2.

Thematic Exemplar of Complexity of Coverage Landscape

Theme: Complexity of coverage landscape
Subtheme: Temporal features
“A lot of our patients have concerns when [State ADAP] is slow sending out the payments because it causes insurance companies to cancel their plans.” (Participant 21: southeast, community-based setting)
[serves rural population]…“transportation is a huge barrier so trying to get people enrolled in the plan [during open enrollment] is such a time crunch.” (Participant 27: midwest, clinic/health-system setting)
“So they pick a pharmacy and I do a plan comparison and I find out the pharmacies were bought out and no longer in network so it changes at the last minute….during open enrollment I was able to get their plan switched and saved them over $86,000 for the year.” (Participant 27: midwest, clinic/health-system setting)
“I would say the biggest challenge was just having people get the required documentation in…verifying eligibility for tax credits and verifying citizenship.” (Participant 34: west, community-based setting)
Subtheme: Uncertainties in a nested federal, state, local knowledge and context
“I think being someone who can communicate and link people—letting them know what's going on at the state level [is important].” (Participant 1: midwest, clinic/health-system setting)
“We've recently expanded [Medicaid] so folks still don't know what they are eligible for.” (Participant 6: southeast, state/local government setting)
“With our current political climate the last two open enrollments have been more stressful in general.” (Participant 23: west, clinic/health-system setting)
“Helping clients is never black and white, the guidelines are not clear. I have encountered problems with every single person I have enrolled.” (Participant 30: southeast, community-based setting)

After each quote, there is information about the participant who stated the quote: “(Participant number: region, setting).”