Oct, 01, 2021

How State-Based Marketplaces Can Maximize Consumer Outreach during Open Enrollment

Julie Bataille, GMMB

As state-based marketplaces (SBMs) get ready for the next annual open enrollment period for health insurance, for many it represents a renewed opportunity to build on the hard work and lessons learned that took place over the year to enroll individuals in quality and affordable health coverage. The extension of special enrollment periods for much of the last year and availability of subsidies from the American Rescue Plan Act (ARP) now mean that nationally 12.2 million Americans  have health coverage through federally facilitated or state-based marketplaces. Of those 12.2 million, 2.8 million of them are newly enrolled in coverage.

As open enrollment approaches, the challenge for SBMs is getting all consumers to check out their options for the coming year and find the health coverage that best meets their needs now. In addition, for those new to the marketplace, SBMs will need to help these individuals navigate a process that may be unfamiliar.

Many SBMs are making concerted efforts to connect residents with public and private health coverage options and are continuing to communicate the new financial help available through ARP. Millions have filed for unemployment since the beginning of the pandemic – many losing their employer-sponsored health coverage or experiencing financial instability along the way. The ongoing COVID-19 pandemic continues to bring uncertainty for consumers and a need for marketplaces to continue to respond to that reality. It is more important than ever to conduct outreach, provide enrollment assistance, and clearly communicate with consumers what health coverage options are available for them in 2022.

Messaging and Marketing to Meet the Moment

Research shows that affordability remains the primary barrier to coverage. The subsidies now available are driving premiums down significantly, with consumers saving $40/month on average in premiums during the special enrollment period.

Building off the outreach strategies implemented during special enrollment periods earlier this year, SBMs are continuing to employ messaging and communication strategies to reach their audiences. Marketplaces are using messaging that reinforces the availability of lower premiums to convey the large numbers of consumers who have qualified for them during the year, and states should continue messaging that specifies the benefits and services covered to address consumer questions and get them enrolled.

Additionally, messaging and outreach that makes a concerted effort to help consumers review their plan choices is especially important given that some still do not know about the increased subsidies – and for those above 400 percent of the federal poverty level, they are not used to shopping on the marketplace.

In addition, marketplaces remain focused on making sure the right messages reach consumers. For example, many SBMs are using data to target and maximize marketing dollars to key audiences and are coming up with creative ways to do just that.

Mindful that audiences continue to consume more information online and that individuals and communities are at varying comfort levels for in-person events due to ongoing COVID-19 health and safety concerns, leveraging a combination of digital, mass media and on the ground outreach to reach consumers where they are continues to be important.

Direct to Consumer Contact

Developing targeted outreach strategies and messaging for consumers that may be less familiar with the open enrollment and the marketplace process will be especially important this year. This includes consumers that qualified for a free marketplace plan because they received unemployment insurance or received free COBRA premiums through September and those that are first-time consumers in the marketplace. To reach these consumers, SBMs have an opportunity to recognize their unique circumstances and tailor messages to them through direct communication including text and email. SBMs can leverage their own data to reach out to consumers with specific steps they can take based on their circumstances and where they are in the enrollment process – reminding them what they need to do to choose coverage for next year and where to get help with questions if needed.

For example, since 2018, HealthSource RI (HSRI) has been using a texting program as a targeting tool to reach specific populations that need special assistance. Most recently, they implemented text campaigns for consumer groups who qualified for additional financial assistance, due to the American Rescue Plan Act (ARP), and now could benefit from switching to a plan with lower deductible and out-of-pocket costs. This includes bronze enrollees who had leftover tax credits after the new ARP subsidies became available and were good candidates to find a less expensive plan option and individuals who paid monthly premiums late. Additionally, as part of their retention strategy, HSRI began surveying customers, via text message, who had lost coverage due to non-payment. The responses from these text messages were tracked and provided to the Operations team, so that the team could conduct live outbound calling to determine what options are available for the customers, including helping them enroll in no-cost coverage via Medicaid.

Outreach and Education

Outreach to consumers continues to take a hybrid approach with many states recognizing the need to hold both in-person and virtual opportunities to educate and enroll consumers in coverage options. Additional federal support for navigators in federally facilitated marketplaces is a welcome change and something many SBMs are continuing to support as well. Marketplaces are also making concerted efforts to reach directly into communities with remaining numbers of uninsured to provide information about coverage options from trusted on the ground partners.

For example, as part of Maryland Health Connection’s commitment to health equity, the SBM continues to organize virtual events to engage with community leaders representing Black and Hispanic/Latino Marylanders and reach the people they serve. Typically, the SBM would leverage paid media dollars to secure added value, such as radio remotes from enrollment events. In 2020, when in-person events were not an option, the state organized Facebook Live events, hosted by Black radio stations with extensive reach. They hosted “Barbershop Conversations” in partnership with Live Chair Health, an organization that brings instant access to health care resources – including the marketplace – to barbershops in Maryland. The Facebook Live was moderated by a radio station DJ and featured a barber and local navigator discussing their community, health, and coverage.

In addition, to develop deeper community relationships, Pennsylvania conducted the Pennie Health Equity Tour in partnership with the YMCA. The 2021 Health Equity Tour is a 12-month series of events taking place throughout the 67 counties in Pennsylvania to raise awareness about access to health coverage and health resources. During the tour, YMCA staff educate attendees on how to obtain insurance through the state-based marketplace.

Applying Lessons Learned

A commitment to help consumers know about and make informed choices about their coverage options and a focus on improving equity will continue to shape the outreach and education efforts for marketplaces again this year. As open enrollment begins with the continued backdrop of the COVID-19 pandemic, marketplaces are applying lessons learned from the past year to continue to make sure as many residents as possible access quality and affordable health insurance.