Report: What We’ve Learned From Two Years of Affordable Care Act Enrollment

By William Tomasko

As of this week, two open enrollment periods have come and gone, and 11.4 million Americans now have health insurance on the marketplaces — with millions more newly covered by Medicaid.

How did those Americans find out how to sign up? Who gave them help along the way? Which strategies proved to be most effective to reach them? And what’s the future outlook looking like for the third open enrollment period — and beyond?

Our new State of Enrollment report, released yesterday, addresses those questions and many more. The report draws from the latest data to analyze all aspects of outreach and enrollment.

We’re excited to share lessons we’ve learned from the outreach and enrollment campaign that contacted more than 6 million consumers leading up to and during the second open enrollment period.

Here are five key takeaways — click here to read the full report:

  • Financial help remained the most important motivator for consumers to enroll in coverage. The Get Covered Calculator, which provides consumers with personalized estimates of how much financial help they are eligible to receive, was the most popular page on the Get Covered America website. Half of the consumers who used the calculator found they could get a plan for less than $100 a month, and those consumers were twice as likely to begin the enrollment process as those who faced more expensive options.
  • The new Get Covered Connector tool made it easier for consumers to get enrollment assistance. During the first open enrollment period, consumers who sat down with an in-person assister were nearly twice as likely to successfully enroll in coverage, so Enroll America developed a new online tool that allowed consumers to quickly schedule appointments with assisters and get text message and email reminders. More than 57,000 appointments were scheduled using the Connector during the second open enrollment period.
  • Year-round outreach was important both to reach consumers who were eligible to enroll immediately through Medicaid, CHIP, or Special Enrollment Periods (SEPs), but also to identify uninsured consumers eligible for marketplace coverage, but not an SEP, ahead of open enrollment. Because consumer outreach began early in the interim period before the second open enrollment, there was time to follow-up multiple times with interested consumers to answer their questions and encourage them to enroll.
  • Doubling the number of partners helped to reach a wider audience. Leading up to and during the second enrollment period, Enroll America engaged 4,600 partners — double the number of organizations it worked with during the first enrollment cycle — who helped to reach even more consumers in year two. Thanks in part to new partnerships with colleges and universities, faith institutions, small businesses, and public school districts, Enroll America was able to host many more enrollment events, including nearly doubling events with bilingual enrollment assistance in densely populated Latino markets.
  • Enroll America placed a stronger emphasis on sharing information about the fine, since a third of consumers who got covered during the first enrollment period reported that it was one of the motivating reason for them to enroll. In email message testing, all instances of mentioning the fine along with the deadline performed better than just mentioning the deadline.
  • The tax filing moment created a particularly powerful opportunity to highlight financial help and capitalize on the real impact of the fine to motivate consumers to take action. Enroll America teamed up with TurboTax on a consumer education campaign. TurboTax embedded the Get Covered Connector on their website, which resulted in 3,000 referrals to in-person assistance by the end of OE2.

We know this work isn’t even close to being over. Individuals and organizations across the country are going to continue to connect Americans to health coverage, and they will continue to make sure new enrollees are able to keep their coverage.

The lessons in this report are intended to light the way for the ongoing effort to help Americans get covered and stay covered.

And you won’t want to miss the second national State of Enrollment conference this June 10-12 in Washington, D.C. At the conference, you’ll be able to connect with other health coverage leaders from across the country and hear expert insight as we get ready to move forward. Click here to learn more and register — the early-bird rate is still available through April 13, and scholarships are available.

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