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Effectiveness of Letters to Increase Health Insurance Enrollment | JAMA

JAMA Health Forum


In this RCT, we found that a low-cost letter, targeting individuals who took the first steps toward enrolling in ACA marketplace coverage but stopped short of selecting a plan, caused statistically significant and meaningful increases in ACA health insurance enrollment. From 2017 to 2020, enrollment in the ACA marketplaces declined from 12.2 million to 11.4 million in part because of a reduction in marketing and advertising. As the Biden administration seeks to expand coverage, particularly among racial and ethnic minorities hard hit by the COVID-19 pandemic, this study provides evidence that low-cost outreach—especially messages informed by the behavioral sciences—could help increase ACA marketplace enrollment.

Media advisory: The full study is linked to this news release.

ACCESS THE STUDY HERE: https://jamanetwork.com/journals/jama-health-forum/fullarticle/10.1001/jamahealthforum.2022.0034?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=030422

This is an open access article distributed under the terms of the CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium. You are not required to obtain permission to reuse this article content, provided that you credit the author and journal.

About JAMA Health Forum: JAMA Health Forum has transitioned from an information channel to an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.

What The Study Did: This randomized clinical trial investigated if low-cost letters motivating individuals to finish enrolling in Affordable Care Act marketplace coverage could increase health insurance enrollment.

Authors: Andrew Feher, Ph.D., of Covered California in Sacramento, California, is the corresponding author.


Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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For more information, contact JAMA Network Media Relations at 312-464-JAMA (5262) or email media relations.

SOURCE: https://media.jamanetwork.com/news-item/effectiveness-of-letters-to-increase-health-insurance-enrollment/; https://jamanetwork.com/journals/jama-health-forum/fullarticle/2789707?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=030422


Yokum D, Hopkins DJ, Feher A, Safran E, Peck J. Effectiveness of Behaviorally Informed Letters on Health Insurance Marketplace Enrollment: A Randomized Clinical Trial. JAMA Health Forum. 2022;3(3):e220034. doi:10.1001/jamahealthforum.2022.0034

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