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Research Letter
September 23, 2019

Association Between Having an Automatic Reenrollment Option and Reenrollment in the Health Insurance Marketplaces

Author Affiliations
  • 1Graduate School of Public Health, Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Duke Margolis Center for Health Policy, Durham, North Carolina
JAMA Intern Med. Published online September 23, 2019. doi:https://doi.org/10.1001/jamainternmed.2019.3717

Of the 11.4 million US health insurance marketplace enrollees in 2019, 3.4 million were automatically reenrolled based on their marketplace coverage in 2018.1 Marketplace enrollees are automatically reenrolled in their current health plan the following year unless they actively change their enrollment status by discontinuing their coverage or selecting a new plan. Enrollees who actively select a plan have been reported to make better plan choices2; however, requiring enrollees to make a plan selection each year may be associated with their becoming uninsured.3 In January 2019, the Centers for Medicare & Medicaid Services requested public comments on eliminating automatic reenrollment for marketplace enrollees.4 While evidence suggests that administrative barriers to reenrollment are associated with reductions in Medicaid coverage,5 it is unknown whether elimination of automatic reenrollment is associated with decreases in reenrollment in the marketplaces.

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