Evaluating the Effect of Automatic Plan Assignment and Enhanced Outreach of Marketplace Take-up

N/AEnrolling By InvitationNCT06709794

Covered California30,000 enrolled

Overview

Facilitated enrollment offers a potential solution to some administrative burdens and choice frictions that may produce incomplete take-up of marketplace coverage. Because Covered California, California's ACA individual marketplace, and Medi-Cal, California's Medicaid program, share an eligibility system, Covered California has the ability to identify individuals who are eligible for marketplace coverage upon losing Medicaid eligibility. This evaluation will compare the effectiveness of facilitated enrollment strategies, including personalized plan pre-selection and personalized quotes of net premiums, to other enhanced, but general outreach tactics, on marketplace take-up among individuals losing Medi-Cal coverage.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

DOUBLE

Enrollment

30,000

Conditions

Outreach Intervention

Interventions

In addition to a standard eligibility notice informing participants of their eligibility for marketplace coverage, they receive an informational flyer describing what Covered California is, the availability of financial assistance, and information on benefit design and private insurance terminology, such as deductibles and copays

Modified eligibility notice with plan informationBEHAVIORAL

a modified eligibility notice that includes information on the pre-selected lowest-cost silver health insurance plan with a personalized quote for their net premium amount in addition to the informational flyer and instead of a standard eligibility notice

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Individual in a single-member household * Discontinued from Medi-Cal * Eligible for Covered California program * Ineligible for APTCs on initial application * Did not attest to planning to file taxes within their Covered California application Exclusion Criteria: * Consumer case is no longer active within the application system * Consumer is already actively enrolled in a marketplace plan * Consumer has already restored Medi-Cal eligibility * A consumer's Special Enrollment Period has ended * Consumer is no longer listed as a single-member household * Consumer was procedurally denied from Medi-Cal coverage due to no response * Consumers has a MAGI Medi-Cal income less than 138% of the Federal Poverty Level (FPL)

Outcomes

Primary Outcomes

Enrollment

a binary indicator for whether a consumer has at least one month of effectuated coverage a Covered California plan that started within the 90 days of their Special Enrollment Period (SEP) following loss of Medi-Cal coverage

Time frame: within calendar year since the loss of Medicaid

Secondary Outcomes

Tenure

Tenure with Covered California (measured in months)

Time frame: within 1-2 years after treatment assignment

Uninsured

A binary indicator for whether someone self-reported being uninsured while filing their taxes;

Time frame: within 1-2 years from the treatment assignment

Consumer engagement

A binary indicator for consumer engagement including calls to service center, creation of and logins to user account, plan shopping on the website, agent delegation after eligibility determination;

Time frame: within 90 days from the treatment assignment

Office visit

A binary indicator for whether someone had an office visit to the medical practitioner during 1-2 years since the intervention;

Time frame: during 1-2 years since the treatment assignment

Prescription filled

A binary indicator for whether someone had a prescription drug fill during 1-2 years since the intervention;

Time frame: during 1-2 years since the treatment assignment

Emergency room visit

A binary indicator for whether someone had an emergency room or department visit during 1-2 years since the intervention

Time frame: during 1-2 years since the treatment assignment

Hospital admission

A binary indicator for whether someone had a hospital admission 1-2 years before and during 1-2 years since the intervention

Time frame: 1-2 years before and during 1-2 years after the treatment assignment

Out-of-pocket health care spending

Total out-of-pocket spending for the 1-2 years since the intervention

Time frame: during 1-2 years since the treatment assignment

Evaluating the Effect of Automatic Plan Assignment and Enhanced Outreach of Marketplace Take-up

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes