Increasing marketing spending at Covered California has translated into a modest increase in Google search activity early on. (Credit: Google Trends)
Managers of HealthCare.gov and Covered California are back to producing data to answer two big marketing questions: How much do traditional, high-cost outreach efforts really help sales, and how well do cheaper digital strategies work?
The Affordable Care Act (ACA) public exchange programs, or web-based supermarkets for health insurance, have now started helping people buy individual and family coverage from commercial health insurers throughout the United States.
The individual major medical open enrollment period for 2020 coverage — or time when people can buy coverage without showing they have what the government classifies as a great reason to be shopping for coverage — is set to run through Dec. 15 in most of the country.
In California, the biggest U.S. state, the open enrollment period for 2020 started Oct. 15 and is set to run through Jan. 15.
The History
Back in 2009, the ACA drafters wanted states to set up and run their own state-based public exchange programs, to help residents shop for health coverage on an apples-to-apples basis, and to use federal premium tax credit subsidies to pay for the coverage.
At that point, Republicans were on the sidelines. Democrats who wanted a government-run health finance system were going up against Democrats who wanted to keep commercial carriers in the system. The Democrats who favored keeping commercial carriers in the system saw the exchange program as a way to make the health finance system cheaper and better, by forcing carriers to compete harder for consumers' business.
The U.S. Department of Health and Human Services (HHS) set up HealthCare.gov to provide exchange account signup and administration services for residents of states that are unwilling or unable to handle all ACA public exchange activities themselves. HHS runs HealthCare.gov through the Center for Consumer Information and Insurance Oversight (CCIIO), an arm of the Centers for Medicare and Medicaid Services (CMS).
HealthCare.gov officials reported this summer that agents and brokers helped with 44% of 2019 HealthCare.gov coverage enrollees sign up for coverage.
Covered California officials reported in January that agents helped 48% of Covered California's 2019 enrollees sign up for coverage. About 33% of the enrollees signed up without live-human help, and 12.5% came in through a service center representative.
The Numbers
The ACA exchange system helped about 11.4 million people sign up for health coverage during the open enrollment period for 2019 coverage, according to CMS. The number of enrollees was down 3.3% from the total for 2018 coverage.
The number of enrollees who were new to the system fell 27%, to 2.7 million.
The number of returning enrollees increased about 7%, to 8.7 million.
HealthCare.gov says it had 44,644 individual market agents and brokers registered as of Oct. 31, up 9% from the year-earlier total. A slidedeck showed that about 7,000 of its agents help with an average of more than one enrollment per business day.
At Covered California, signups fell 0.5%, to 1.5 million, according to a February board meeting executive director's report.
New signups fell 24%, to 295,980.
