From the Journals

Automatic reenrollment helps keep people insured



More people remain insured when enrollment is automatically renewed year over year, compared with those who do not have the option of automatic reenrollment, according to research appearing in JAMA Internal Medicine

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Researchers looked at 123,244 households in California that were enrolled in marketplace plans that exited the state in 2015. Of the 781 households that were not automatically reenrolled in other plans, the unadjusted and adjusted enrollment rates were 21.4% and 21.5%, respectively. Researchers adjusted for a variety of household characteristics, including age of the oldest household member, household size, receipt of tax credit subsidy, and other factors. Of the 122,463 with the option to reenroll, unadjusted and adjusted enrollment was 51.2%.

The research comes as the Centers for Medicare & Medicaid Services is contemplating the elimination of automatic reenrollment in marketplace plans.

“Elimination of automatic reenrollment would likely be associated with decreases in the number of enrollees who remain insured through the marketplaces,” research authors Coleman Drake, PhD, University of Pittsburgh, and David Anderson, Duke Univeristy, Durham, N.C., wrote in a letter (JAMA Intern Med. 2019 Sep 23. doi: 10.1001/jamainternmed.2019.3717).

“As an opt-out policy similar to that used in other health insurance markets such as Medicaid, automatic reenrollment may be associated with increases in continuity of coverage in the marketplaces by reducing administrative barriers to reenrollment,” the authors continued.

Dr. Drake and Mr. Anderson noted that losing automatic reenrollment was associated with a decrease in enrollment, but more study is needed particularly because the group that lost reenrollment was small.

“Households with different demographics or different experiences may have behaved differently if they had lost the option to automatically reenroll,” they state. “Losing automatic reenrollment because of a policy change rather than an insurer exit also may be associated with households behaving differently. Given the magnitude of our findings, it is critical that future studies continue investigating the association between automatic reenrollment and continuity of coverage.”

SOURCE: Coleman D, Anderson A. JAMA Inter Med. 2019 Sep 23. doi: 10.1001/jamainternmed.2019.3717.

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