This brief explores Marketplace facilitated enrollment programs as a means of increasing health coverage among eligible people. We summarize existing programs, discuss considerations for states exploring them, and note key design issues.

WHY IT MATTERS

More than half of uninsured Americans are eligible for subsidized coverage. Complex application processes are a key barrier to enrollment in coverage. Streamlining the consumer experience is key to increasing take-up. Ultimately, this may require Congress to change our highly segmented system to simplify eligibility rules and require fewer coverage transitions. But in the meantime, states have options to smooth these transitions and ease enrollment.

KEY FINDINGS

• The past few years have seen a burst of facilitated enrollment programs among state Marketplaces, with 19 states currently having at least one facilitated enrollment program.
• Predominant models include tax return–based easy enrollment, programs leveraging administrative data from other state programs, programs facilitating transitions from Medicaid, and programs that effectuate enrollment for those who fail to select a plan.
• It is too early to measure the effectiveness of these programs, but they appear to be cost-effective compared with other means of expanding coverage like state-funded subsidies.
• So far, these have been pursued primarily by state-based Marketplaces, but the federal Marketplace and other state agencies could adopt similar programs.