Marketplace Enrollment Procedures

Barriers experienced during marketplace enrollment and promising strategies select states have implemented to overcome these barriers are presented in this report.

The Issue:

Barriers identified in the report include Medicaid backlogs, procedural challenges for disadvantaged populations and difficulty with plan selection.

Key Findings

Promising State Strategies Include:

  • Washington’s marketplace avoided Medicaid backlogs by using the Medicaid program’s computer eligibility system to make rapid Medicaid determinations while applicants for insurance affordability programs are still on-line.

  • Application assisters in multiple states have helped consumers overcome technical barriers to enrollment.

  • California, Connecticut, and other states have simplified consumer choices by standardizing plan designs within each metal tier.  


A number of states offer promising examples suggesting how enrollment obstacles can be overcome. Other states and the federal government can build on these examples, improving the enrollment process for 2015 and beyond.

About the Grantee:

The Urban Institute is a nonprofit, nonpartisan policy research and educational organization that examines the social, economic and governance problems facing the nation. For more information, visit Follow the Urban Institute on Twitter or Facebook More information specific to the Urban Institute’s Health Policy Center, its staff, and its recent research can be found at