Outreach Strategies for Health Insurance Enrollment

(MAPS Trial)

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Covered California

Disqualifiers: Active marketplace plan, Restored Medi-Cal, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests different methods to assist individuals who were on Medi-Cal, California's Medicaid program, in signing up for new health insurance through Covered California. The researchers aim to determine if providing more personalized information, such as a suggested health plan and cost details, aids in enrollment. Participants will include individuals who recently lost Medi-Cal coverage, are eligible for Covered California, but have not yet enrolled in another plan. As an unphased trial, this study allows participants to contribute to research that could enhance the enrollment process for many others.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these outreach strategies are safe?

In a previous study, CMS found that 24.2 million people successfully signed up for health plans through the ACA Marketplace. This finding indicates that the enrollment process is generally easy and safe. The study focuses on improving how people sign up for health insurance, not on testing a medical treatment that might have side effects. Therefore, no known safety concerns exist with the automatic plan assignment and enhanced outreach strategies tested in the trial. The trial aims to simplify choosing and enrolling in health plans, so participants should not worry about any risks related to the process itself. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to increase health insurance enrollment, making it easier for people to get covered. Unlike traditional methods that simply inform individuals of their eligibility, this trial tests enhanced outreach with detailed informational flyers and pre-selected plans tailored to individual needs. The Enhanced Outreach arm provides clear explanations of financial assistance and insurance terms, helping people understand their options better. The Pre-Selected Plan arm goes a step further by suggesting the most affordable insurance plan upfront, complete with a personalized cost estimate. These strategies aim to simplify the enrollment process and potentially boost coverage rates, offering a fresh approach to tackling low insurance enrollment.

What evidence suggests that this trial's enrollment strategies could be effective?

Research has shown that better outreach methods can help more people sign up for health insurance. In this trial, participants in the Enhanced Outreach arm will receive informational flyers, which studies have found can simplify understanding of choices and encourage selecting a health plan. This method aims to reduce confusion and simplify decision-making, leading to increased enrollment.

Participants in the Pre-Selected Plan arm will receive information on a specific, low-cost plan along with a personalized cost estimate. Evidence suggests that this approach can increase the likelihood of signing up. Both strategies in this trial aim to simplify the process, enabling more people to obtain the coverage they need. ^{2 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for individuals in California who are eligible for marketplace coverage after losing Medicaid eligibility. It aims to evaluate if facilitated enrollment strategies can help people sign up more easily compared to general outreach methods.

Inclusion Criteria

Did not attest to planning to file taxes within their Covered California application

I am no longer covered by Medi-Cal.

Individual in a single-member household

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

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive either a standard eligibility notice, enhanced outreach, or a pre-selected plan with personalized quotes

90 days

Follow-up

Participants are monitored for outcomes such as prescription fills, emergency room visits, and insurance status

1-2 years

What Are the Treatments Tested in This Trial?

Interventions

• Automatic Plan Assignment and Enhanced Outreach

Trial Overview The study is testing the effectiveness of two approaches: automatic plan assignment with personalized details like pre-selected plans and net premium quotes, versus enhanced but general outreach tactics like informational flyers.

How Is the Trial Designed?

Group I: Pre-Selected Plan Experimental Treatment 1 Intervention

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.

Group II: Enhanced Outreach Experimental Treatment 1 Intervention

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.

Group III: Control group Active Control 1 Intervention

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

Who Is Running the Clinical Trial?

Covered California

Lead Sponsor

Trials

2

Recruited

90,000+

Citations

1. cdn.clinicaltrials.gov cdn.clinicaltrials.gov/large-docs/94/NCT06709794/Prot_SAP_000.pdf

1 Evaluating the Effect of Facilitated Enrollment and ... Data and Data Structure. Outcomes: We use Covered California administrative data to examine health insurance take-up behavior and health care ...

2. clinicaltrials.gov clinicaltrials.gov/study/NCT07136233

Impact of Benefit Inserts on Health Plan Selection and ... The study aims to evaluate the impact of an informational flyer insert on health plan selection and health care utilization among Covered ...

3. patlynk.com patlynk.com/trial/NCT07136233

Educational Flyers on Enhanced CSR Plan Enrollment and ... The study will evaluate two main outcomes: whether people enrolled in other insurance tiers decide to switch to the enhanced CSR plans upon ...

4. kff.org kff.org/medicaid/key-lessons-from-medicaid-and-chip-for-outreach-and-enrollment-under-the-affordable-care-act/

Key Lessons from Medicaid and CHIP for Outreach ... However, effective outreach and enrollment efforts will be key to ensuring that new coverage opportunities translate into increased coverage. Based on a review ...

5. withpower.com withpower.com/trial/phase-outreach-intervention-2-2024-25e9e

Outreach Strategies for Health Insurance Enrollment ... Trial Overview The study is testing the effectiveness of two approaches: automatic plan assignment with personalized details like pre-selected plans and net ...

6. cms.gov cms.gov/newsroom/press-releases/over-24-million-consumers-selected-affordable-health-coverage-aca-marketplace-2025

Over 24 Million Consumers Selected Affordable Health ... CMS reports that 24.2 million[1] consumers selected plan year 2025 coverage through the Marketplaces during the 2025 Marketplace Open Enrollment ...

7. federalregister.gov federalregister.gov/documents/2025/06/25/2025-11606/patient-protection-and-affordable-care-act-marketplace-integrity-and-affordability

Patient Protection and Affordable Care Act; Marketplace ... This rule revises standards for coverage denial, reenrollment, open enrollment, premium tax credits, and aims to strengthen ACA integrity and ...

8. info.nystateofhealth.ny.gov info.nystateofhealth.ny.gov/sites/default/files/EnrollmentReport2024a.pdf

2024 NY State of Health Coverage Update Note: NYSOH data shows that individuals enrolling in Bronze plans in the 2024 Open Enrollment. Period are most likely to have higher incomes ...

9. cbpp.org cbpp.org/research/health/five-key-changes-to-aca-marketplaces-amid-uncertainty-over-premium-tax-credit

Five Key Changes to ACA Marketplaces Amid Uncertainty ... A new methodology for calculating the premium adjustment percentage will result in a 2.7 percent increase in marketplace net premiums after APTC ...