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Field
Trial Status
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Before
on_going
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After
completed
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Field
Abstract
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Before
With the passage of the American Rescue Plan (ARP) in March 2021, more consumers than ever before are now eligible for $1 per member per month (PMPM) health insurance coverage across the ACA Marketplaces. But many individuals may not be aware of the new subsidies, or of their eligibility for Cost-Sharing Reduction (CSR) Silver plans. This project's goal is to examine whether personalized letters and email reminders can increase (1) health insurance enrollment and (2) CSR Silver take-up.
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After
With the passage of the American Rescue Plan (ARP) in March 2021, more consumers than ever before are now eligible for free health insurance coverage across the ACA Marketplaces. But many individuals may not be aware of the new subsidies, or of their eligibility for Cost-Sharing Reduction (CSR) Silver plans. This project's goal is to examine the effects of personalized letters and email reminders.
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Field
Last Published
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Before
June 22, 2021 10:08 AM
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After
June 20, 2022 07:17 PM
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Field
Intervention (Public)
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Before
In May 2021, we identified 44,000 households who submitted a Covered California application for the 2021 coverage year, were found eligible for a $1 CSR Silver 94 plan but yet to enroll. We then randomly assigned households to one of three arms: (1) a Control group assigned to receive no letter or emails during the month of June 2021, a (2) a Generic outreach group assigned to receive a letter and email reminders about the availability of $1 plans, or (3) a Personalized outreach group assigned to receive a letter and email reminders informing them that they are eligible for a $1 PMPM Enhanced Silver 94 plan.
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After
In May 2021, during a Special Enrollment Period (SEP) in California's ACA Marketplace, we identified 44,000 households who submitted a Covered California application for the 2021 coverage year, were found eligible for a $1 CSR Silver 94 plan but yet to enroll. We then randomly assigned households to one of three arms: (1) a Control group assigned to receive no letter or emails during the month of June 2021, a (2) a Generic outreach group assigned to receive a letter and two email reminders about the availability of $1 plans, or (3) a Personalized outreach group assigned to receive a letter and two email reminders informing them that they are eligible for a $1 PMPM Enhanced Silver 94 plan.
The second intervention took place during the 2022 Open Enrollment Period (OEP). At the end of November 2021, we identified 11,245 households with an email address who submitted an application for the 2022 coverage year, were found eligible for a $0 CSR Silver 94 plan but not yet enrolled. We then randomly assign households to either a control group or a personalized outreach group that received a letter along with two email reminders informing them that they are eligible for a $0 Enhanced Silver 94 plan.
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Field
Primary Outcomes (End Points)
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Before
This randomized evaluation has three primary outcomes: (1) an indicator for whether the household selected a Covered California plan, (2) an indicator for whether the household selected a CSR Silver plan and (3) an indicator for whether the household’s plan selection has a $1 PMPM net premium. We will measure outcomes at three points in time: the end of June 2021, the end of July 2021 and the end of August 2021.
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After
This study includes four outcomes of interest for each of the experiments: indicators for (1) whether a household enrolled in ACA coverage by the end of the intervention period, (2) whether a household selected a CSR Silver plan, (3) whether a household was paying $1/month or $0 and (4) retention. For the SEP experiment, retention is defined as whether a household was still enrolled in December 2021 (four months after the end of the intervention), and for the OEP experiment, whether the household was still enrolled in May 2022 (four months after the end of Open Enrollment).
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Field
Experimental Design (Public)
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Before
Households were randomly assigned to one of three arms: (1) a Control group assigned to receive no letter or emails during the month of June 2021, a (2) a Generic outreach group assigned to receive a letter and email reminders about the availability of $1 plans, or (3) a Personalized outreach group assigned to receive a letter and email reminders informing them that they are eligible for a $1 PMPM Enhanced Silver 94 plan.
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After
Households in the SEP experiment were randomly assigned to one of three arms: (1) a Control group, (2) a Generic outreach group, or (3) a Personalized outreach group.
Households in the OEP experiment were randomly assigned to one of two arms: (1) a Control group or (2) a Personalized outreach group.
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Planned Number of Observations
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Before
44,000 households
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After
44,000 households in the SEP experiment and 11,245 households in the OEP experiment.
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Field
Sample size (or number of clusters) by treatment arms
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Before
11,000 were assigned to the Control group, 16,500 were assigned to the Generic treatment group and 16,500 were assigned to the Personalized treatment group.
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After
SEP experiment: 11,000 were assigned to the Control group, 16,500 were assigned to the Generic treatment group and 16,500 were assigned to the Personalized treatment group.
OEP experiment: 5,622 were assigned to the Control group and 5,623 were assigned to a personalized treatment group.
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Field
Power calculation: Minimum Detectable Effect Size for Main Outcomes
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Before
The intervention will run for approximately four weeks in the month of June 2021. Given the short duration of the intervention, we expect the baseline health insurance take-up rate to be under 5 percent, based on prior evaluations among applicants referred by the Medicaid eligibility system. In a pairwise comparison (e.g. Control vs. Personalized treatment), we are powered at the 80% level to detect a 0.5 percentage point difference in health insurance take-up rates.
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After
We expect the baseline health insurance take-up rate to be under 5 percent, based on prior evaluations among applicants referred by the Medicaid eligibility system. In a pairwise comparison (e.g. Control vs. Personalized treatment), we are powered at the 80% level to detect a 0.5 percentage point difference in health insurance take-up rates.
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Field
Secondary Outcomes (End Points)
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Before
Secondary outcomes will include plan effectuation, duration of coverage and estimated out-of-pocket expenses.
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After
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Field
Building on Existing Work
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Before
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After
No
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