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

Not Applicable

• Conditions: Outreach Intervention

• Registration Number: NCT06709794
• Lead Sponsor: Covered California

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.

Detailed Description

Not available

Study Timeline

• Study Start: 2024-03-25
• Status Verified: 2024-11
• Study First Submitted: 2024-11-18
• Study First Submitted QC: 2024-11-25
• Last Update Submitted: 2024-11-25
• Study First Posted: 2024-11-29
• Last Update Posted: 2024-11-29
• Primary Completion: 2026-12-31
• Study Completion: 2028-12-31

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 30000

Inclusion Criteria

• 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

Exclusion Criteria

• Consumer case is no longer active within the application system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)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Enrollment	within calendar year since the loss of Medicaid	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

Secondary Outcome Measures

Name	Time	Method
Hospital admission	1-2 years before and during 1-2 years after the treatment assignment	A binary indicator for whether someone had a hospital admission 1-2 years before and during 1-2 years since the intervention
Out-of-pocket health care spending	during 1-2 years since the treatment assignment	Total out-of-pocket spending for the 1-2 years since the intervention
Tenure	within 1-2 years after treatment assignment	Tenure with Covered California (measured in months)
Uninsured	within 1-2 years from the treatment assignment	A binary indicator for whether someone self-reported being uninsured while filing their taxes;
Consumer engagement	within 90 days from the treatment assignment	A binary indicator for consumer engagement including calls to service center, creation of and logins to user account, plan shopping on the website, agent delegation after eligibility determination;
Office visit	during 1-2 years since the treatment assignment	A binary indicator for whether someone had an office visit to the medical practitioner during 1-2 years since the intervention;
Prescription filled	during 1-2 years since the treatment assignment	A binary indicator for whether someone had a prescription drug fill during 1-2 years since the intervention;
Emergency room visit	during 1-2 years since the treatment assignment	A binary indicator for whether someone had an emergency room or department visit during 1-2 years since the intervention

Trial Locations

Locations (1)

Covered California; 🇺🇸 Sacramento, California, United States