As of midnight last night, the ACA health insurance exchanges on healthcare.gov and most if not all of the state based marketplaces have re-opened to at least a very broad and loose special enrollment period if not a full open enrollment period.
I have a piece coming in the next few days with a co-author on what to expect. I expect some enrollment gains, but right now, the big changes between this open enrollment period and the COVID general special enrollment period is elite political messaging and some paid advertising. The paid advertising is only a difference in states and media markets that served by Healthcare.gov.
Paul Shafer and I had looked at the impact of presidential statements and administrative actions on enrollment in the ACA individual marketplace. We had looked at the change in enrollment in the last two weeks of January 2017 after the change in administration with a concurrent whirlwind of elite anti-ACA messaging: “It’s failed”, “it’s bad” “going to replace it with something so much better….”
We had found a significant decrease in enrollments (depending on the model we used 24% to 30%) in the last two weeks of 2017 compared to what we should have expected given our counterfactual was that 2017 enrollment under the Obama Administration was trending very tight to 2016 enrollment at the same point in time and it was running even to slightly ahead. We think that this was due to the change in administration, messaging and policy as similar changes in direction for ACA information seeking behaviors were seen in Kentucky when a Republican governor who was a loud and strong opponent of the ACA replaced a Democratic governor who was very supportive of the ACA.
We have good evidence that changes in political administration that replace pro-ACA elite support with anti-ACA elite support can keep marginal buyers from making an active choice to enroll. We don’t have good evidence that moving from anti-ACA elite messaging to pro-ACA elite support will produce the opposite but equal enrollment reaction, yet. I hypothesize that pro-ACA elite support is valuable and useful but the challenge is that the decision to enroll requires active choices to be made and then actual actions to be taken. Doing something instead of doing nothing is a bigger ask, in my opinion, than doing nothing instead of doing something.
Lymie
What the heck is elite in this context?
Barbara
@Lymie: Support from upper political echelons of government.
jonas
A year or two ago I recall listening to the lady in some place like NC or TN being interviewed on NPR. She was a total trainwreck health-wise, had some measly minimum-wage job with no benefits, was continually stressing about her health care, but when the reporter asked why she didn’t go to healthcare.gov and sign up for Obamacare (it would have been practically free for her with subsidies), she was like “oh, no. I don’t want anything to do with that.” When asked why, she mumbled something about how she “didn’t care for that man.”
Elite messaging or not, some people are just idiots.
jeffreyw
I’m happy to see Joe open up Bidencare like this.
Ruckus
@jonas:
Well a good plan takes that into consideration. A bad plan unfortunately does as well. In KY they called it something different and fairly well wiped out the idiot level course of action. Of course that was when you didn’t have idiots running the state.
glc
You definitely don’t mean “the opposite” here. Offhand I can’t think of a word that goes here meaning a sign change – “that the effect of positive messaging would be comparable.”
Maybe it works as written, but for me it was one of those things one reads twice.
Ronno2018
Can you write a post about the change in Medicaid work requirements? https://www.washingtonpost.com/health/biden-ends-medicaid-work-requirements/2021/02/11/74b51d78-6cc3-11eb-9f80-3d7646ce1bc0_story.html