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States take varying paths to insurance marketplace re-enrollment

Even with auto-renewal in place, states emphasize importance of shopping around

States running their own health insurance marketplaces are under pressure to re-enroll those who bought plans last year but taking varying approaches to doing so, according to a report from the Urban Institute.

The federal approach to auto-renewal for those who do not go back in and specifically renew their coverage is to extend the same absolute dollar amount of enrollees' 2014 premium subsidy to their 2015 coverage. The six states studied in this report--California, Colorado, Kentucky, Maryland, Rhode Island and Washington--take different approaches to re-enrollment.

Two of them, Maryland and Rhode Island, don't allow auto-renewal at all. Enrollees must go back to the marketplace and renew or be cut off. Those states cite dramatic changes in plans and prices, as well as technical difficulties in offering auto-renewal. The other four states do allow auto-renewal.

At the same time, Kentucky, Maryland, Rhode Island and Washington were able to adjust enrollees' financial assistance to reflect the updated cost of the 2015 benchmark plan and offer them a more accurate determination of their subsidies than in the states using the federal marketplace, the report says.

These states, however, still stress that it's important for enrollees to go back into the marketplace to shop for a better deal. Kentucky officials point out they have two new insurers and want consumers to see the new plans.

All six states invest heavily in outreach and communication strategies to help enrollees understand what they need to do and the deadlines they face. Kentucky launched a mobile tour touting its marketplace, set up a shopping mall storefront and ran advertisements on radio, TV, and social media.

Two states, Colorado and Washington, changed their messaging strategies to de-emphasize auto-renewal and encourage enrollees to return to the marketplace and shop after analyses showed that was in consumers' best interest.

The states cited several re-enrollment barriers. These include IT--technical problems as well as overcoming consumers' poor experiences of last year--along with insufficient customer support infrastructure, messaging creating confusion about deadlines, and the short time frame for re-enrollment.

Seven in 10 Americans who bought their 2014 health insurance through the federal or state marketplaces responding to a Gallup poll said they were happy with the cost and quality of their coverage--which could be a disincentive for them to shop around this year.

Meanwhile, the federal auto-renewal process could have "painful" repercussions for insurers, a report from Milliman concludes.

To learn more:
- find the Urban Institute report (.pdf)

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What auto-enrollment for exchanges means for insurers
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GAO: Major players dominate private insurance market
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