Sep, 01, 2020

Adjusting Open Enrollment Outreach to Meet a New Moment

Julie Bataille and Caitlin Hodes, GMMB

A new open enrollment landscape created by the continued health and economic impacts of the COVID-19 pandemic, a national movement calling for racial justice, and the concurrent timing of a presidential election year is raising new challenges for states as they plan outreach and enrollment campaigns. Marketplaces are reimagining their campaign strategies to meet this moment, with plans to operationalize virtual activities, communicate with new and existing audiences, and reflect changing consumer behaviors in their outreach tactics. We recently hosted a 2-part webinar series on preparing for OEP 2021 that highlighted several strategies states can pursue to help ensure a successful open enrollment period this year.

Address consumer anxieties about health care and cost

Four in ten Americans report trouble affording basic necessities or falling behind on household or medical bills in the past 3 months.[1] And current projections estimate that by the end of 2020, 10.1 million people will no longer have employer-sponsored health insurance or coverage that was tied to a job they lost because of the pandemic.[2] As a result, more Americans have sought health coverage through special enrollment periods and may continue to do so as we head into the annual window of open enrollment. This means many new consumers could come to the marketplace to purchase a health plan or may find themselves newly eligible for Medicaid coverage. Consumers are looking to health insurance providers and government agencies as trusted sources of help and information.

Given the very real challenges of consumers having to prioritize health insurance against competing basic needs, and new customer bases to reach, it is crucial to emphasize straightforward information about health coverage, underscore the affordability of plans and acknowledge consumer anxieties in messaging. For example, Connect for Health Colorado’s job loss toolkit leverages messaging that addresses the reality in which many residents are finding themselves, while also highlighting basic information about the marketplace. It will be important to prepare navigators, brokers and assisters that more people may be searching for coverage for the remainder of 2020 (including during the OEP 2021 timeframe), especially if more permanently lose their jobs and employer sponsored insurance. States will want to send the message that enrollment is open while paying special attention to the coverage year consumers are signing up for—and to encourage those signing up for 2020 coverage to consider a plan for 2021 as well. 

Prioritize digital efforts

We continue to see steady increases in media consumption and time spent online during the pandemic. States should take advantage of these shifts in behavior by elevating their digital presence and creating additional engagement opportunities, including on social platforms. This could include hosting a Twitter chat like Nevada Health Link, or leveraging micro-influencers within your target audiences like beWellNM. And when it comes to engaging existing customer bases, states should utilize digital tools and data to conduct targeted email and text campaigns. States can further elevate their digital presence by ensuring that advertising allocations reflect the changing landscape. Although traditional media remains important, given the steady growth of connected TV[3], states should consider those platforms in their paid advertising allocations.

Plan for virtual outreach and enrollment events

While some marketplaces are continuing to offer in-person assistance with COVID-19 safety precautions in place, many are leaning on virtual substitutes to help consumers enroll safely. Multi-user platforms such as Zoom or WebEx can be used for webinars, virtual summits, or conferences, which states are increasingly holding to prepare navigator and broker networks and to educate consumers. Marketplaces should be mindful of technology barriers that may exist within target populations. For example, states will want to counteract assumptions that advanced technology tools or WiFi connections are required to enroll by emphasizing that phone enrollment assistance is available, and bridge existing gaps by leveraging community partners such as local libraries to establish WiFi partnerships for safe enrollment settings. 

Ensure a focus on equity across efforts

COVID-19 has further elevated existing disparities in health outcomes and coverage—communities of color have been hardest hit by the pandemic both in terms of infection and death rates. Nationwide data shows us that Black people are dying at 2.4 times the rate of White people, and Hispanic or Latino people are dying at nearly 1.5 times the rate of White people.[4] In addition, the ongoing systemic and institutional racism in our country is taking a toll on the health and wellbeing of Black Americans in particular—55 percent report that discrimination is a significant source of stress.[5] This landscape creates even more urgency to address health equity through open enrollment campaigns—including by ensuring paid media targeting prioritizes those who remain disproportionately uninsured, building robust community partner connections, and conducting earned media outreach to outlets widely read by communities of color. For more information, see our piece ‘Addressing Equity through COVID-19 Response: Communications Approaches in States’ to learn more about how equity was at the forefront of state responses to COVID-19 this spring and how these same tactics can be continued through open enrollment.

Leverage agencies with direct consumer touchpoints

Building on the natural opportunities for increased coordination and partnership with state agencies during COVID-19, states should think strategically about how to continue this integration long-term to reach consumers where they are seeking benefits for other services. States should continue to provide links, materials, and messaging to departments of labor and unemployment agencies leading up to OEP to reach residents who have recently lost employment, and possibly their health insurance. As unemployment numbers rise, the connection with these agencies will remain critical.

While this open enrollment period will look unlike any other, states are stepping up to the challenge and coming up with innovative strategies to ensure consumers are supported, informed and equipped to sign up for health insurance at this critical time. No doubt, marketplaces will be tracking what works, making adaptations in real time, and considering what tactics to continue even once the pandemic is over.


[1] https://www.kff.org/coronavirus-covid-19/report/kff-health-tracking-poll-july-2020/

[2] https://www.rwjf.org/en/library/research/2020/07/changes-in-health-insurance-coverage-due-to-the-covid-19-recession–preliminary-estimates-using-microsimulation.html

[3] https://www.nielsen.com/us/en/insights/article/2020/connected-tv-usage-remains-above-pre-covid-19-levels-as-traditional-tv-viewing-normalizes/

[4] https://covidtracking.com/race

[5] https://theharrispoll.com/wp-content/uploads/2020/07/MDC_THP_CuratedConversation_FutureHealthcare_072920_forDist.pdf