Using Personalized Letters and Emails to Increase Health Insurance Take-up and Improve Plan Choice Quality

Using Personalized Letters and Emails to Increase Health Insurance Take-up and Improve Plan Choice Quality in California's ACA Marketplace

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT05216458

Enrollment

44000

Registered

2022-01-31

Start date

2021-05-27

Completion date

2021-08-31

Last updated

2022-01-31

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Health Behavior

Keywords

Affordable Care Act, randomized controlled trial, nudge, American Rescue Plan

Brief summary

With the passage of the American Rescue Plan (ARP) in March 2021, more consumers than ever before are now eligible for $0 -- or $1 per member per month (PMPM) in Marketplaces that include abortion coverage -- health insurance coverage across the ACA Marketplaces. But many individuals may not be aware of the new subsidies, or of their eligibility for Cost-Sharing Reduction (CSR) Silver plans. This project's goal is to examine whether personalized letters and email reminders can increase health insurance enrollment, CSR Silver take-up and $1 PMPM coverage.

Interventions

BEHAVIORALEmails and letter intervention

Emails and letters for households assigned to the treatment group

BEHAVIORALControl group

No outreach during the intervention period.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

OTHER

Masking

SINGLE (Subject)

Eligibility

Sex/Gender

ALL

Healthy volunteers

Inclusion criteria

* Submitted a Covered California application for the 2021 coverage year and found eligible for a $1 PMPM Enhanced Silver 94 plan

Exclusion criteria

Design outcomes

Primary

Measure	Time frame	Description
Percent of households enrolled in an ACA plan	Three months	Percent of households enrolled in an ACA plan based on Covered California administrative data
Percent of households who chose a CSR Silver plan	Three months	Percent of households in a CSR Silver plan based on Covered California administrative data
Percent of households who enrolled in a $1/month net-of-subsidy premium plan	Three months	Percent of households who enrolled in a $1/month net-of-subsidy premium plan based on Covered California administrative data

Secondary

Measure	Time frame	Description
Percent of households who logged into their online account	Three months	Percent of households who logged into their online account based on Covered California administrative data

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026