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OpenTrials
Completed

NCT Number: NCT05891418

Effect of Email Nudges on Plan Switching and Healthcare Utilization Among Unemployment Insurance Recipients

In March 2021, President Biden signed into law the American Rescue Plan Act of 2021 (ARP), a landmark federal economic relief and stimulus package designed to provide support to Americans hit by the economic recession brought about by the COVID-19 global pandemic. The law provides increased federal premium tax credits (PTC), and ensures that consumers will pay no more than 8.5 percent of household income on health insurance premiums in 2021 and 2022, if enrolled through an Affordable Care Act marketplace like Covered California.

The ARP also provides additional PTC and cost-sharing reduction (CSR) benefits to eligible marketplace enrollees who report receiving unemployment insurance benefits (UIB) for at least one week in 2021. Under the law, for 2021 only, Covered California consumers will have their household income level treated as if it were at 138.1 percent of the federal poverty level (FPL), regardless of their projected annual income, which will make them eligible for a Silver 94 plan, and which offers the greatest value on cost-sharing benefits.

But in order to access those cost-sharing benefits, households must be in silver tier plans, but over 40,000 were not. This project's goal is to assess the effects of an informational email on plan switching into Cost Sharing Reduction Silver plans and downstream healthcare utilization.

The project's research design is a randomized intervention among approximately 42,500 enrolled households with an email address in non-silver tier plans. The investigators randomly assigned to either two informational emails or to a no email control group. The investigators then collected administrative data to examine plan switching behavior and healthcare utilization among households in the study.

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Key information

Conditions

Health Behavior Behavior

Age range

0 year–74 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Covered California

Sacramento, California, 95815, United States

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Has email address, in a non-silver plan and reported unemployment insurance in 2021

Exclusion criteria

  • In a silver plan, no email address

Treatment and study plan

Two informational emails with plan information

Behavioral

Informational emails about the benefits of Cost-Sharing Reduction Silver plans.

Standard notice of eligibility determination

Behavioral

No extra outreach during intervention period.

Primary outcomes

  1. Cost-Sharing Reduction Silver Enrollment

    Time frame: 1 month

    Percent of households enrolled in a Cost-Sharing Reduction Silver Plan

  2. Office Visit

    Time frame: 6 months

    Percent of households with an office visit

  3. Prescription drug use

    Time frame: 6 months

    Percent of households with a prescription drug fill

  4. Emergency room visit

    Time frame: 6 months

    Percent of households with an emergency room visit

  5. Hospitalization

    Time frame: 6 months

    Percent of households with a hospitalization

Sponsors and collaborators

Lead sponsor

Office of Evaluation Sciences

Fed

Registry information

Important dates

Study start
2021
Primary completion
2021
Study completion
2021
First posted
Jun 6, 2023
Registry last updated
Jun 6, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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