Press Release

Embargoed Until Contact

December 22, 2014

Sue Ducat
Director of Communications
(301) 841-9962




This year open enrollment under the Affordable Care Act (ACA) began on November 15, allowing new customers to sign up for health insurance. Open enrollment also provided current policyholders the chance to change plans and request a redetermination on the amount of subsidy they received. During this second year of open enrollment for the ACA's insurance Marketplaces, insurers and policy makers are working to keep last year's enrollees in the system--and the Department of Health and Human Services (HHS) estimates that 95 percent of them are eligible for automatic renewal. A new policy brief from Health Affairs and the Robert Wood Johnson Foundation examines the pros and cons of reenrollment options for consumers, whether they are using the federal Marketplace or live in states that operate their own exchanges. Automatic reenrollment means that almost seven million people already enrolled will not necessarily need to flood and exchanges during open enrollment. On the other hand it also may discourage consumers from exploring alternative coverage that might better fit their needs and get a more accurate determination of eligibility for subsidies.


Topics covered in this brief include:


      • What's the background and the law? The brief traces how states and the federal government have begun to use automatic renewal for programs such as the Children's Health Insurance Program (CHIP), Medicare, and Medicaid, which has also become the standard operating practice for employer-sponsored plans. As the brief explains, the ACA requires the federally operated Marketplace to obtain updated information only from enrollees who received a premium, thereby automatically reenrolling everyone else who signed up last year unless they took action. In addition, the brief reviews the strategies taken by a few of the state-operated exchanges.

      • What's the debate? As some critics of automatic enrollment have observed, while automatic enrollment is easy, consumers would serve themselves well by comparing the costs and benefits of available plans, since wide swings in premiums may be expected for the first few years of the ACA. Comparison shopping is particularly important for people receiving tax credits or cost-sharing reductions because of their price sensitivity. The brief details other impediments awaiting enrollees changing plans, such as the risk of being double billed and heavy Web traffic at the end of the enrollment period.

      • What's next? This year's open enrollment has faced few of the technical problems encountered a year ago. Going forward, HHS is exploring alternative reenrollment scenarios in which premiums would be taken into account. On the legal front, the US Supreme Court is expected to rule by June 2015 on King v. Burwell. Although that ruling is unlikely to affect 2015 enrollment, a decision invalidating premium subsidies for states relying on the federal Marketplace could drastically alter the entire exchange landscape.
About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print, with additional Web First papers published periodically and health policy briefs published twice monthly at Read daily perspectives on Health Affairs Blog. Download weekly Narrative Matters podcasts on iTunes.