Insights from We All Benefit Funding Opportunity

More than 12% of Central Texans do not have health insurance, meaning it is harder and more expensive for them to access timely and responsive health care. Many of these individuals are eligible for health insurance through Medicaid or the federal Marketplace, but complicated and burdensome enrollment processes are often a major barrier to successfully enrolling in insurance coverage. In response, in 2024, St. David’s Foundation launched the We All Benefit funding opportunity and invested in 16 organizations to help Central Texans enroll in health insurance benefits or support eligibility and enrollment processes through outreach, education, training, or premium assistance. Access to affordable health coverage is also a critical foundation for economic stability, helping individuals and families avoid medical debt and maintain the financial security needed to support long-term health and wellbeing.

One year into the two-year funding initiative, early learnings are informing and shaping future funding strategies. The Foundation is incredibly grateful to the cohort of organizations for sharing their insights with us as they continued to do this work during a period of significant policy and funding changes. Below are early themes emerging from We All Benefit work that is underway:

Insight #1: Through effective outreach and enrollment practices, organizations were able to help historically marginalized community members enroll in health insurance amidst changes to eligibility and other policy changes that have narrowed the pathway to health coverage enrollment.

In the past 18 months, We All Benefit grantees enrolled more than 27,000 individuals in Medicaid, CHIP, Marketplace, or MAP coverage, navigating a rapidly shifting policy landscape. Federal policy changes announced in 2025 reduced eligibility and created confusion for many community members who were previously eligible for Medicaid and CHIP, while funding for navigation services was dramatically reduced. At the same time, the expiration of Enhanced Premium Tax Credits for 2026 Marketplace plans reduced the amount of financial assistance, leading to confusion and hesitancy among individuals who remained eligible for low-cost plans. Together, these changes have added stress and confusion to an already complicated system – one that is often not designed with consumers in mind. As a result, the role of trained benefits navigators has become both more essential and challenging.

Insight #2: In a rapidly changing policy environment, connections to policy experts and peer organizations also navigating enrollment systems helped organizations maintain the expertise needed to help community members overcome administrative barriers to enrollment.

Organizations that provide enrollment support must maintain a certain level of expertise to help community members navigate the complex benefits systems – and sustaining that expertise requires ongoing effort. Recent policy changes and persistent administrative barriers have made this work increasingly labor-intensive, stretching the capacity of organizations already doing a lot with a little. Connections with policy experts have eased this burden for enrollment organizations through training, accessible resources for both enrollment staff and community members, real-time support to address emerging questions, and connections to state agencies. These supports are critical to ensuring enrollment organizations can continue to effectively serve their communities.

Insight #3: Organizations overcame overwhelming misinformation and fear through deep trust-building, human connection, and patience—often built over years of building trusted relationships in the communities they serve. Culturally responsive practices that acknowledge fears and confusion equip community members to make informed decisions for themselves and their families.

Many historically marginalized community members have a well-founded fear and mistrust of systems. The organizations that remain trusted resources for these community members are those who have built deep connections, prioritize human connection, and practice cultural responsiveness in their work. They understand why community members may not want to enroll in public benefits, and they offer unbiased and accurate information so that community members can make informed decisions for themselves and their families. It is also important to acknowledge that building and maintaining this trust—and working with clients as they overcome growing fears and mistrust—requires an increasingly significant amount of time and effort which must be accounted for in terms of funding and staffing expectations.

Looking Ahead
As a regional health foundation, St. David’s Foundation plays a role in supporting organizations that help community members navigate these enrollment systems and access the coverage that supports both health and economic stability. In addition to expanding our understanding of what benefits enrollment looks like in our community,

insights from the We All Benefit grantees have informed a new funding opportunity, We All Benefit 2.0: Building Economic Stability, in the following ways:

• Expanded Scope. We All Benefit 2.0 will broaden enrollment support beyond health insurance to also include enrollment support for food security (e.g., WIC, SNAP) and income supports (e.g., Earned Income Tax Credits), reflecting the interconnected nature of this work. While health insurance is an important component of economic stability, we hope to expand and deepen our impact by investing in holistic approaches that increase access to food and income supports as well. This expanded scope recognizes the relationship between health and economic stability.
• Prioritizing Expertise AND Trust. To ensure community members have greater success with enrollment processes, we will prioritize funding for organizations that have the necessary expertise to effectively help marginalized populations understand and enroll in public benefits as well as possess the deep trust and culturally responsive practices necessary to connect with historically marginalized community members.
• Longer Duration. This funding opportunity will extend for 3 years, recognizing that building effective organizational infrastructure that has a path to sustainability takes time.

The We All Benefit 2.0: Building Economic Stability funding opportunity opens on March 30, 2026. More details about the call can be found here.