Reenrollment: Challenges and Opportunities

Two young women fill out an enrollment form.

HHS estimates that about 95% of people who are enrolled through will be eligible for automatic renewal.

What's the Issue:
The first open enrollment period under the Affordable Care Act (ACA) was fraught with technical problems with the federal marketplace, as well as many state-run exchanges. Despite these problems, just under seven million people purchased a health plan through one of the marketplaces, making the first open enrollment period a qualified success. The first open enrollment focused on building awareness of the marketplaces and the requirement to have health insurance, as well as getting people to apply and enroll in a plan.

During subsequent open enrollment periods, state and federal officials will devote more efforts to keeping people enrolled, as well as trying to enroll hard-to-reach populations. Policies sold through the marketplaces follow the calendar year and are set to terminate on December 31 unless they are renewed. The federal marketplace, and some state exchanges, are automatically renewing policies for some enrollees unless they take action themselves.

What's Next?
Open enrollment began November 15 and thus far has been going much more smoothly than the first open enrollment. People who want to change their plan must have done so by De­cember 15 in order to avoid any gap in cover­age. Enrollees who do not shop around and are automatically renewed may be surprised with their new premium. People in states using the federally facilitated Marketplace or following its procedures, whose income or family situ­ation has changed since their 2013 tax filing but who have not requested a redetermination with the new information, may find the size of their premium tax credit covers a smaller por­tion of their premium than in 2014. There may be backlash from people who find themselves paying more for the same plan and who are not receiving the full subsidy for which they are eligible.

In recognition of the price sensitivity of en­rollees, HHS is rethinking the automatic re-enrollment process for future open enrollment periods. In the recently released proposed rule on benefit and payment parameters, HHS stat­ed that it is exploring alternative automatic re-enrollment scenarios in which premiums would be taken into account.



Media Contacts

Melissa Blair

Robert Wood Johnson Foundation (609) 627-5937

Additional Media Contact: Sue Ducat

Health Affairs (301) 841-9962