Poster #86 - Personalized plan recommendations ease consumer decisions with marketplace health insurance enrollment

• In Event: Saturday Poster Luncheon

Abstract

Background: Individuals churning from Medicaid to marketplace coverage may be unfamiliar with aspects of private insurance and face administrative burdens when enrolling (Herd and Moynihan, 2018; KFF, 2024). The number of options and health insurance terminology increases cognitive burden, potentially leading consumers to abandon health insurance enrollment process (K.M. Eriksson and Snyder, 2017). Facilitated enrollment offers a potential solution to overcome some administrative burdens and choice frictions that may result in incomplete take-up of marketplace coverage.  

Purpose: To determine whether enhanced messaging or personalized plan pre-selection impacts enrollment take-up among individuals disenrolled from Medicaid and found eligible for marketplace coverage.

Methods: In this randomized control trial in California, individuals disenrolled from Medicaid and potentially eligible for marketplace premium tax credits were randomly assigned to one of three groups. All groups received a standard notice, informing them of their marketplace eligibility.  Treatment arm one received the standard notice and an informational flyer about plan benefits, description of financial assistance, and terminology of private insurance aspects. Treatment arm two received a modified notice with information on a pre-selected health plan, personalized net premium amount, and how to enroll through a customized online journey.

Results: Preliminary data, among 8,900 individuals, shows that 15.1% of control group enrolled in marketplace coverage. Take-up among treatment arm one was 17.5% but is not statistically different from the control group. Take-up among treatment arm two was 21.8%, a 6.7 percentage point increase compared to the control group, or a 45% relative increase.  

Conclusions: Simplifying the enrollment process by providing personalized information on a pre-selected health insurance plan helps increase take-up of marketplace coverage when compared to standard eligibility and enhanced messaging practices. As marketplaces explore strategies to reduce the number of consumers going uninsured due to changes in coverage eligibility, creating streamlined enrollment pathways offers a promising mechanism to increasing take-up. 

Trial Registration: ClinicalTrials.gov Identifier: NCT06709794

Authors

• Marina Lovchikova, California Department of Health Care Access and Information
  Presenting Author

• Emory Wolf, State of California
  Non-Presenting Co-Author