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

NCT06709794 | Enrolling By Invitation

• 1 other identifier: CCA-MAPS-2024
• Study Type: interventional
• Target: 30,000
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Outreach Intervention

Outcome Measures

Primary Outcomes (1)

• 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

  within calendar year since the loss of Medicaid

Secondary Outcomes (8)

• Tenure

  within 1-2 years after treatment assignment

• Uninsured

  within 1-2 years from the treatment assignment

• Consumer engagement

  within 90 days from the treatment assignment

• Office visit

  during 1-2 years since the treatment assignment

• Prescription filled

  during 1-2 years since the treatment assignment

Study Arms (3)

Control group

NO INTERVENTION

A control group that receives a standard eligibility notice informing them of their eligibility for marketplace coverage.

Enhanced Outreach

EXPERIMENTAL

A treatment group that receives a standard eligibility notice informing them of their eligibility for marketplace coverage and 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.

Behavioral: Informational flyer

Pre-Selected Plan

EXPERIMENTAL

A treatment group that receives 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, as well as the informational flyer.

Behavioral: Modified eligibility notice with plan information

Interventions

Informational flyer BEHAVIORAL

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

Enhanced Outreach

Modified eligibility notice with plan information BEHAVIORAL

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

Pre-Selected Plan

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• 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

You may not qualify if:

• 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)

Sponsors & Collaborators

• Covered California: lead

Study Sites (1)

Covered California

Sacramento, California, 95620, United States

Location

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Deputy Director, Evaluation & Research

Study Record Dates

• First Submitted: November 18, 2024
• First Posted: November 29, 2024
• Study Start: March 25, 2024
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2028
• Last Updated: November 29, 2024

Record last verified: 2024-11

Locations

US (1)