Working Paper: NBER ID: w30885
Authors: Keith Marzilli Ericson; Timothy J. Layton; Adrianna McIntyre; Adam Sacarny
Abstract: Administrative barriers to social insurance program take-up are pervasive, including in subsidized health insurance. We conducted a randomized controlled trial with Massachusetts’ Affordable Care Act marketplace to reduce these barriers and other behavioral frictions. We find that a “check the box” streamlined enrollment intervention raises enrollment by 11%, more than personalized reminder letters (7.9% increase) or generic reminder letters (4.5% increase). Effects are concentrated among individuals eligible for zero-premium plans, who faced no further administrative burdens of setting up payments. Producing this enrollment effect through premium reduction would cost about $6 million in subsidies, highlighting the importance of these burdens.
Keywords: administrative barriers; health insurance; enrollment; field experiment; subsidized coverage
JEL Codes: D73; I13
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| streamlined enrollment process (I23) | enrollment in subsidized health insurance (I13) |
| personalized information letter (Y20) | enrollment in subsidized health insurance (I13) |
| generic reminders (Y90) | enrollment in subsidized health insurance (I13) |
| streamlined enrollment process (I23) | enrollment for zero-cost plans (I13) |