Researchers estimate that, every year, 33.5 million people experience a life-changing event—such as a job layoff terminating employer-sponsored insurance—that ends their coverage for at least part of the year while making them eligible to enroll in marketplace plans outside standard open enrollment periods, like the one taking place now. Such special enrollment periods (SEPs) let eligible consumers remain seamlessly insured.
Prepared by researchers at the Urban Institute with funding from the Robert Wood Johnson Foundation, a new brief finds that by far the most frequent trigger of SEP eligibility is job loss that ends employer-sponsored insurance. The second most common SEP involves consumers whose increased income terminates their Medicaid eligibility. The brief also shows the number of uninsured who qualify for SEPs by age, income, race, education, and employment status.
The researchers find that, in 2014, fewer than 15 percent of the uninsured who qualified for SEPs used them to enroll in marketplace plans. They suggest that both consumers and marketplaces could benefit if healthcare.gov and state marketplaces developed application assistance and enrollment campaigns that focus specifically on life events that trigger SEPs.
“So far, the impact of special enrollment periods has been underwhelming, but there is clearly an opportunity to increase enrollment,” said Kathy Hempstead, who directs coverage issues at the Robert Wood Johnson Foundation. “Each year millions of people experience events that qualify them for special enrollment, so enhanced outreach may be effective in boosting take-up.”
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