Study: Feds Should Align ACA Open Enrollment Period, Tax Season
More low-income U.S. residents would be likely to sign up for health coverage through the Affordable Care Act's insurance exchanges if the annual open enrollment period is aligned with the period when most people file their tax returns and receive their refunds, according to a new study published in Health Affairs, Modern Healthcare's "Vital Signs" reports (Demko, "Vital Signs," Modern Healthcare, 6/25).
For the study, Katherine Swartz of the Harvard School of Public Health and John Graves of Vanderbilt University School of Medicine analyzed Google search results between January 2004 and December 2013 to evaluate consumers' mindset about their finances, taxes and health coverage during particular times of the year (DuBois, Tennessean/USA Today, 6/25).
The researchers noted that previous studies by behavioral economists and experimental psychologists have been able to identify when people are financially stressed or when a person's decision-making capacity is stretched thin, meaning that they are unable to make sound decisions (Radnofsky, "Washington Wire," Wall Street Journal, 6/26).
Under the ACA, the 2015 open enrollment period is scheduled to take place between Nov. 15, 2014, and Feb. 15, 2015. In later years, the enrollment period is expected to conclude before the end of the calendar year, according to "Vital Signs" ("Vital Signs," Modern Healthcare, 6/25). The dates were selected to align with the traditional Medicare sign-up period and the time many U.S. residents renew their employer-based health plans ("Washington Wire," Wall Street Journal, 6/26).
Swartz and Graves found that consumers often searched for terms such as "payday loan" and "cash advance" during the end of the year amid the holiday season, which indicated financial stress. They wrote, "The holiday season between Thanksgiving and New Year's -- with pressures for buying presents, travel and the onset of winter home-heating bills -- strains many family budgets."
As a result, individuals are less likely to consider or be able to purchase health insurance during that period ("Vital Signs," Modern Healthcare, 6/25). Consumers also tended to conduct online searches using terms relating to health insurance during the typical tax filing and tax refund months, the authors noted. A 2014 Urban Institute report found that 75% of U.S. residents receive a tax refund, which averages $3,000.
Swartz and Graves noted that low-income consumers who qualify for tax subsidies tend to reach out to public financial advisers and tax filing centers, which could help them sign up for exchange coverage at the same time. In addition, financial and tax advisers could help inform more individuals about the tax penalty for not signing up for coverage, the authors said.
George Brandes --- vice president of health care programs at the tax firm Jackson Hewitt and a proponent of aligning the enrollment period with the annual tax season -- said, "You're talking about something that is a central transaction in the annual financial calendar of Americans," adding, "This is the largest injection of liquidity into consumers' hands every year."
Separately, Swartz said that HHS could use its authority to shift the timing of the upcoming open enrollment periods, noting that such an action would not require large financial investments or congressional approval. In the study, Swartz and Graves recommended that the health department move the next enrollment period to between Feb. 15 and April 15 next year (Tennessean/USA Today, 6/25).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.