A Closer Look: Perspectives on the 2019 Marketplace Open Enrollment Period

To better understand how various policies unfolded during open enrollment for ACA-related coverage in 2019, the Robert Wood Johnson Foundation (RWJF) engaged Mathematica to assess outreach and enrollment strategies and outcomes. In addition to interviewing Navigators and assisters about their frontline work with consumers, we conducted case studies of new initiatives in Maryland, New Jersey, and South Carolina to try to reach and enroll consumers into Marketplace coverage. Key findings included: (1) There was a drop in overall Marketplace enrollment by about 300,000 consumers from 2018, largely drive by a drop in new enrollees; (2) Federal Navigator and advertising budget cuts were noticeable and detrimental to consumers; (3) While public charge discussions caused fear and confusion in some communities, the effect on enrollment is unclear; and (4) Short-term plans were not as problematic as expected. In the face of declining resources for outreach andenrollment, we observed that states and organizationsare looking for new investments and policy solutions,with some success. For example, case studies identified a promising model for transitioning from Navigator to non-profit insurance agency in South Carolina, and found that a new investment in advertising about more affordable Marketplace coverage in Maryland seems to have had the desired effect, with total enrollment up, suggesting messages about affordability resonated with consumers. While efforts to promote enrollment in New Jersey were perceived as beneficial to consumers, Marketplace enrollment fell in the state this year. The brief concludes with some suggestions for potential areas funders could consider for future investments to keep the goals of the ACA afloat.