Three Successes and Three Areas for Improvement from the Third Open Enrollment Period

The last days of an open enrollment period are a sprint. Before each annual deadline to sign up for health insurance through the Affordable Care Act’s marketplaces, I see how hard staff, partners, and volunteers push themselves to reach as many people as possible.

But the weeks after each year’s deadline are also crunch time. Even before the dust settles, it’s time to figure out what we learned. Our staff and partners dive into the data, debrief with each other, sift out the most successful best practices, and plot out what needs to happen to make future years even more successful.

We are busy at work doing that post-enrollment analysis now, but looking back on this past year’s third open enrollment period (OE3), we can already identify three things that worked well — and three areas to improve upon.

What worked:

  1. 4 million new consumers enrolled through the marketplaces. The numbers don’t lie: More people are still interested in getting covered, even as the national spotlight moves away from Affordable Care Act enrollment. Although the pool of eligible uninsured is certainly shrinking, there are clearly still millions of people who want quality, affordable health care who can be brought into the marketplaces.
  1. Last year’s new consumers have become this year’s savvy re-enrollees. In an increase from last year, the vast majority — 70 percent — of this year’s re-enrollees took action to stay covered, even though they could have stayed on autopilot and had their insurance renewed automatically. They were choosy shoppers and checked out whether new plans would fit their needs better for the new year. And this year, for the first time, we saw a bigger spike in sign-ups ahead of the December 15 deadline than for the final deadline. That tells us consumers are getting more engaged and more familiar with the process of starting the year with coverage.
  1. The outreach and enrollment coalition has never been stronger. More than 6,700 partner organizations have come together to meet the needs of consumers in their communities, from offering in-person enrollment help to getting the word out through innovative outreach. We launched the Get Covered Academy ahead of OE3 to equip organizations with tried-and-true tools and tactics, and a survey found 70 percent of Academy partners said their Affordable Care Act outreach was more effective than ever before. When partners implement best practices, consumers win.

At the same time we celebrate success, we know we have further to go to make enrollment even more easily accessible for even more people. First and foremost, we know affordability is the main factor in consumer decision-making, and the availability of quality, affordable options lays the foundation for any successful enrollment effort. And smart, efficient outreach can make the promise of affordable care a living reality.

Here are three ways for future open enrollment periods to improve:

  1. Fill in stubborn knowledge gaps by continuing to invest in outreach and education. More people still need to know key facts about the health coverage landscape under the Affordable Care Act, including how much the fine is and what the deadlines to enroll are. That’s why outreach, education, and enrollment support need to be ongoing, year-round efforts. And it’s time to double down on in-person assistance — people who sat down with enrollment assisters have been nearly 60 percent more likely to successfully enroll.
  1. Double down on making it easier for people to choose the best plan for their needs. Going into OE2, almost half of the uninsured said they weren’t confident they could pick the right kind of coverage for themselves. That’s why, for OE3, we launched the Get Covered Plan Explorer, a digital tool that lets people compare estimates of how much each plan would cost in a year, and which doctors would be covered. Now it’s time to analyze how that tool worked, and how those lessons can be applied to give as many consumers as possible the information they need to get covered with confidence.
  1. Focus on making financial help feel real to people who hadn’t been able to afford health insurance before the Affordable Care Act took effect. Most of the uninsured haven’t taken action to find out if they qualify for financial help to lower their health coverage costs. Over the years and decades, millions of people got used to the idea that quality, affordable health coverage would always be out of reach, just because that had always been the case. Shifting that paradigm will take time. But, year by year, it can sink in for more and more people if we put financial help front and center in every conversation.

Ultimately, those person-to-person conversations are what motivate me – those moments when someone realizes they can finally find a health plan that fits their needs and their budget. And I’m grateful for the tireless, day-by-day work of thousands of committed partners that makes those moments more frequent.

With more consumers joining the marketplace, an increasingly sophisticated pool of enrollees, and a coalition that’s built to last, this community has laid a foundation for lasting success — and it’s ready to take enrollment to even greater heights.


Anne Filipic serves as President of Enroll America, a non-profit organization dedicated to maximizing the number of Americans who enroll in health coverage made available through the Affordable Care Act.

Morning Consult