Special Enrollment Periods in 2014: A Study of Select States

A map of the continental United States.

Research illustrates how state-based marketplaces have managed the enrollment process for consumers who experience life-changing circumstances, qualifying them to enroll in a marketplace plan outside of the normal open enrollment period.

The Issue

The Affordable Care Act created special enrollment periods to help people apply for a marketplace plan when they lose employer-sponsored coverage or Medicaid, get married, or have a child, among other life-changing events that can occur throughout the course of the year. In 2014, experts projected that millions of people would be eligible under these circumstances.

Key Findings

In interviews with marketplace officials and other stakeholders, researchers found special enrollment periods did not function as well as they could have due to:

  • Marketplace website launch issues

  • Limited IT functionality

  • Challenges with consumer outreach and education


As open enrollment periods continue to become shorter, marketplace officials noted that they would focus in greater detail on special enrollment systems and procedures.

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 www.urban.org. Follow the Urban Institute on Twitter www.urban.org/twitter or Facebook www.urban.org/facebook. More information specific to the Urban Institute’s Health Policy Center, its staff, and its recent research can be found at www.healthpolicycenter.org.

About the Center on Health Insurance Reforms

The Center on Health Insurance Reforms at Georgetown University’s Health Policy Institute is a nonpartisan, expert team of faculty and staff dedicated to conducting research on the complex and developing relationship between state and federal oversight of health insurance markets. For more information visit www.chir.georgetown.edu.