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Related Experiment Video

Updated: Jun 14, 2025

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Email Nudges Increased Eligibility Verification And Subsidy Receipt In California's ACA Marketplace.

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Email reminders helped some Affordable Care Act (ACA) Marketplace enrollees renew consent for health insurance subsidies. However, many still missed deadlines, highlighting the need for policy changes to improve subsidy access.

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Area of Science:

  • Health policy research
  • Behavioral economics
  • Public health interventions

Background:

  • Affordable Care Act (ACA) Marketplaces require periodic consent for income-linked premium subsidy verification.
  • Consumers must renew consent to maintain eligibility for subsidies, posing an administrative barrier.

Purpose of the Study:

  • To evaluate the effectiveness of email nudges in increasing consent renewal for ACA Marketplace premium subsidies.
  • To assess the impact of email reminders on continued subsidy receipt.

Main Methods:

  • A randomized experiment involving over 20,000 households in California's ACA Marketplace.
  • Testing the impact of one, two, or three reminder emails on consent updates and subsidy receipt.

Main Results:

  • Three emails increased consent updates by 1.9 percentage points (3.2%) and subsidy receipt by 2.0 percentage points (4.0%).
  • Despite interventions, nearly 40% of households receiving three emails did not update consent by the enrollment deadline.

Conclusions:

  • Email nudges can modestly improve subsidy renewal but do not fully overcome administrative barriers.
  • Policy and structural changes are necessary to reduce barriers and enhance access to Marketplace coverage affordability.