Diving Into the Re-Enrollment Data: Better Understanding Consumer Engagement

By Molly Warren and Zachary Baron

Enroll America is always looking for new ways to harness data to better understand consumers and identify the most effective strategies to help them get covered and stay covered. And as we look ahead to the third open enrollment period (OE3), we’re interested in what the publicly available enrollment data, as well as our own survey research, can tell us about consumer enrollment and re-enrollment experiences to date.

Here are the key takeaways: Lower-income enrollees (getting financial help to reduce their premiums below $50) and people who interacted with Enroll America’s campaign seem to be actively re-enrolling the most.

What the Public Data Show About Re-Enrollment

In March, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the Department of Health and Human Services released their final marketplace enrollment report for OE2. Overall, about half of HealthCare.gov enrollees (53 percent) were new to the marketplace in 2015. Of returning consumers, about half (53 percent) actively re-enrolled their coverage for 2015, and the remaining 47 percent were automatically re-enrolled into the same plan they had last year. And, to drill down further, 56 percent of those who actively re-enrolled switched plans, and the remaining 44 percent chose to stay in the same plan they were enrolled in in 2014. (See Figure 1.)

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The report also includes data on a number of other enrollee characteristics by re-enrollment status, including metal tier of plan selected (Bronze, Silver, Gold or Platinum), percentage who received financial help, and premium (after tax credit). These data give us an idea of how new enrollees are behaving, and, among those re-enrolling for 2015, who more actively engaged in re-enrollment. A few takeaways:

  • Re-enrollees were more likely to choose Silver plans than new enrollees: 66 percent of new enrollees picked a Silver plan compared to 72 percent of re-enrollees.
  • Active re-enrollees were more likely to receive financial help than those who were automatically re-enrolled: Ninety-one percent of active re-enrollees are receiving financial help compared to 84 percent of automatic re-enrollees.
  • New enrollees and active re-enrollees were more likely to have lower premiums compared to automatic re-enrollees: Thirty-seven percent of new enrollees and 33 percent of active re-enrollees have plans for under $50 per month compared to 22 percent of automatic re-enrollees. Conversely, 42 percent of new enrollees and 45 percent active re-enrollees are paying $100+ per month compared to 54 percent of automatic re-enrollees. (See Figure 2.)

Figure-2

Together, these financial help and premium data by re-enrollment status suggest that lower-income enrollees (those getting financial help and tax credits that reduce their premium below $50) disproportionately returned to the marketplace and shopped, while higher-income enrollees (those with premiums greater than $100 and/or without financial help), engaged less. This makes sense since lower-income enrollees are likely more price-sensitive; smaller changes in premiums may spur them to shop for a better deal.

What Enroll America’s Research Shows About Re-Enrollment

At the same time that we examine the publicly available data, Enroll America is also uniquely positioned to add our own insight based on what we learn from our Get Covered America email list of over 1.2 million subscribers. While not nationally representative, surveying this list does provide a helpful window into how the renewal process played out across the country.

To better understand consumer experiences with renewal, Enroll America conducted multiple surveys among those on our consumer email list during and after the close of OE2.* The enrollees we surveyed were significantly more engaged in renewing their coverage than consumers in HealthCare.gov states at large.

  • Those engaged with Enroll America were more likely to compare their options. Roughly 83 percent of consumers we surveyed who reported they were enrolled in marketplace coverage for the second year in a row said that, at a minimum, they compared their plan options during the renewal process (rather than simply letting the marketplace automatically re-enroll them without exploring their options for 2015). This is compared to 52 percent of HealthCare.gov re-enrollees.
  • They were also more likely to switch plans. Slightly less than half (49 percent) of Enroll America consumers who re-enrolled reported that they switched plans from the previous year, compared to less than a third (29 percent) among HealthCare.gov re-enrollees.

Both of these findings show higher levels of consumer engagement among re-enrollees that came in contact with Enroll America’s campaign than among HealthCare.gov re-enrollees overall. (See Figure 3.) While we cannot know with certainty what caused these differences, Enroll America’s unified and simple message for re-enrollees consistently emphasized the need for consumers to take action and the benefits associated with doing so.

Figure-3

As more consumers gain coverage through the marketplace, enrollment stakeholders will need to devote even more attention to efforts that promote retention. Enroll America looks forward to continuing our work in this area and expanding partnerships with other organizations to help consumers be better positioned to renew their coverage. Stay tuned for further analysis of the renewal process from our survey research, effective strategies used by partners, and ways that enrollment stakeholders can amplify our renewal messaging framework.

*The statistics discussed in the latter portion of this blog post come from an email survey Enroll America fielded starting in January 2015. A total of 1,208 consumers responded to the survey, all of whom interacted with Enroll America’s grassroots or digital campaign. Respondents come from the following states (all of which used HealthCare.gov platform during the first and second open enrollment periods): Arizona, Florida, Georgia, Illinois, Michigan, North Carolina, New Jersey, Ohio, Pennsylvania Tennessee, and Texas.

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