What Information Influences Get Covered Calculator Users to Take the Next Step?

By Ricky Gonzales

We’ve known since the first open enrollment period (OE1) that receiving financial help and avoiding the fine were among the biggest motivators for consumers to enroll in coverage. Now a new study using the Get Covered America Calculator details just how important it is to show consumers that they have affordable health insurance options available. In the study, consumers were much more likely to start the enrollment process when shown low-cost options under $100, whereas providing information about the fine alongside the premium estimate did not affect whether they would start enrolling or not.

Key Takeaways for Increasing Enrollment:

  • Continue to prioritize messages about financial affordability. About three in five marketplace enrollees (63 percent) who received tax credits in states using HealthCare.gov have monthly premiums of $100 or less.
  • Continue to provide personalized premium estimates for consumers. Most users of the Calculator saw premium estimates below $100, and they were twice as likely to start the enrollment process as consumers who saw premium estimates of $100 or more. Overall, one in four consumers who used the Calculator went on to start the enrollment process.
  • Continue to message around the fine. Although including information about the fine in the Calculator output did not increase the likelihood that consumers would start the enrollment process, fine information did not hurt either. Given previous evidence from email tests showing that consumers are more likely to take action when told about the fine and surveys showing that consumers generally underestimate the amount of the fine, it is important to continue to inform consumers about the fine for going without health insurance, particularly given that the fine amount increases again for 2016 (to $695 per person or 2.5 percent of income).

Study Details

Between January 23 and February 15, 2015, consumers who used the Calculator to get personalized estimates of financial help and premiums for marketplace plans in their area saw one of four possible results if their inputs suggested they were likely not eligible for Medicaid and they might face a fine for not having health insurance in 2015:

  • No mention of the fine. Consumers only saw what they might expect to pay for premiums, without getting any additional information about the fine.
  • Personalized fine amount. Consumers saw the estimated dollar amount of the fine they might have to pay for being uninsured in 2015, based on their Calculator inputs (ZIP code, income, number of adults and children in household looking for coverage, and total household size).
  • Detailed fine language. Consumers saw that they might face a fine for being uninsured, and that the fine would be “$325 or 2% of income (whichever is more).”
  • Simple fine language. Consumers saw that they might face a fine if they did not get health insurance by February 15, but the amount of the fine was not specified.

After consumers saw the Calculator output, they had the option to click an “Enroll Now” button to get redirected to their online marketplace and start the enrollment process. The fine conditions were assigned at random so that any differences in click-through rates could be attributed to the fine language the consumers saw.

Main Findings

Consumers were just as likely to start the enrollment process when they saw information about the fine

The chart below shows the click-through rates to the enrollment form by fine condition (in the control version, the fine was not mentioned at all). Overall, being exposed to information about the fine did not make consumers more or less likely to start the enrollment process.


None of the differences in click-through rates to the enrollment form are statistically significant at conventional levels. Nevertheless, there was a trend toward the fine language performing better relative to the control group among consumers who faced higher premium costs.

Consumers were much more likely to start the enrollment process when low-priced plans were available

Slightly more than half of all consumers who used the Calculator and received a premium estimate were shown a plan costing less than $100. Only 5 percent of all Calculator submissions returned a premium estimate of $500 or more. However, only 9 percent of those who received the highest premium estimates started the enrollment process, compared to 36 percent of those receiving premium estimates below $100.

 Lowest Calculator Premium Output
Percent of Submissions
Percent Starting Enrollment Process
$0-$100 50.9% 35.9%
$100-$249 29.7% 21.0%
$250-$499 14.0% 13.6%
$500+ 5.4% 9.2%
100% 26.9%

What This Means for OE3

Outreach and enrollment organizations should continue to emphasize affordability and direct consumers to tools like the Calculator to make sure they know that affordable health insurance options are available. At the same time, messaging for consumers who face more expensive health insurance options should focus on explaining why health insurance is a worthwhile investment.

Finally, it will be important to continue to let consumers know about the fine and study how messaging around the fine affects consumers at different points during the enrollment process. The fine for being uninsured in 2016 will increase to $695 or 2.5 percent of income (whichever is higher), so details about the fine might be more motivating for consumers as the cost for going without insurance rises.

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